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NPI Code Detail

MEDICARE: MICHELLE ALFONSO OTR/L

MEDICARE: MICHELLE ALFONSO 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
1225X00000XOccupational Therapist24001CA

General Provider Information

NPI Number : 1750156824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ALFONSO OTR/L
Provider Business Mailing Address
First Line : 1616 247TH ST
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-2061
Country : US
Telephone Number : 310-951-0469
Fax Number :
Provider Business Practice Location Address
First Line : 1929 N FAIRVIEW ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-2205
Country : US
Telephone Number : 714-554-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 11/20/2023

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Directions to “ MICHELLE ALFONSO OTR/L” Practice Location

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