MEDICARE: MS. DEBRA RAE RICKER 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	225XH1300X	Human Factors Occupational Therapist	OT2301	CA
2	225XN1300X	Neurorehabilitation Occupational Therapist	OT2301	CA
3	225XR0403X	Driving and Community Mobility Occupational Therapist	OT2301	CA

General Provider Information

NPI Number	:	1770555302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA RAE RICKER OTR/L

Provider Business Mailing Address
First Line	:	3572 THOR AVE
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3969
Country	:	US
Telephone Number	:	562-760-1400
Fax Number	:	562-799-9926

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3144
Country	:	US
Telephone Number	:	562-760-1400
Fax Number	:	562-799-9926

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	09/11/2025

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