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General NPI Number Information
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NPI Number | 1801741947
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Entity Type | Individual
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Provider Name | KYLIE ANDREA CASSOTTA OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 3840 WOODRUFF AVE STE 211
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City | LONG BEACH
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State | CA
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Zip | 90808-2149
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Country | US
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Telephone | 562-507-1568
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Fax |
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Provider Business Mailing Address
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Address Line | 17491 MASHIE CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-6209
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Country | US
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Telephone | 714-421-8713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 28723
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License Number State | CA
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