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General NPI Number Information
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NPI Number | 1962356196
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Entity Type | Individual
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Provider Name | ALEXA PANGBURN MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 7120 CORBIN AVE
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City | RESEDA
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State | CA
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Zip | 91335-3618
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Country | US
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Telephone | 818-881-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 6653 TYRONE AVE
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City | VAN NUYS
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State | CA
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Zip | 91405-4740
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Country | US
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Telephone | 818-425-0955
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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 | 28755
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License Number State | CA
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