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NPI Code Detail

MEDICARE: OLIVIA ROSE VEGA OTD, OTR/L, CHT

MEDICARE: OLIVIA ROSE VEGA OTD, OTR/L, CHT
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
1225X00000XOccupational Therapist20224CA
2225XH1200XHand Occupational Therapist20224CA

General Provider Information

NPI Number : 1194401117
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA ROSE VEGA OTD, OTR/L, CHT
Provider Business Mailing Address
First Line : 28311 VIA DEL MAR
Second Line :
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-6340
Country : US
Telephone Number : 949-973-8346
Fax Number :
Provider Business Practice Location Address
First Line : 6320 CANOGA AVE FL 15
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-2563
Country : US
Telephone Number : 818-894-2273
Fax Number : 818-357-2505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2023
Last Update Date : 05/07/2026

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