MEDICARE: MRS. PAIGE MATTHEW ALEXIS BUSH

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	225X00000X	Occupational Therapist		CA
2	225700000X	Massage Therapist	73782	CA

General Provider Information

NPI Number	:	1396497020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAIGE MATTHEW ALEXIS BUSH

Provider Business Mailing Address
First Line	:	14689 MOON CREST LN UNIT A
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-4367
Country	:	US
Telephone Number	:	909-230-8730
Fax Number	:

Provider Business Practice Location Address
First Line	:	14689 MOON CREST LN UNIT A
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-4367
Country	:	US
Telephone Number	:	909-230-8730
Fax Number	:

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

Provider Enumeration Date	:	01/24/2022
Last Update Date	:	06/28/2026

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