MEDICARE: ALISON LEIGH ADAMS OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	15773	CA

General Provider Information

NPI Number	:	1174996904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON LEIGH ADAMS OTR/L

Provider Business Mailing Address
First Line	:	30252 TOMAS
Second Line	:	SUITE 100
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30252 TOMAS
Second Line	:	SUITE 100
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2129
Country	:	US
Telephone Number	:	949-459-1658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2015
Last Update Date	:	11/02/2015

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