Provider Demographics
NPI:1003337361
Name:NGO, DEANNA (OTR/L, HTC, PAMS)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:OTR/L, HTC, PAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13772 DEODAR ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7911
Mailing Address - Country:US
Mailing Address - Phone:714-548-9192
Mailing Address - Fax:
Practice Address - Street 1:1310 W STEWART DR STE 203
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3837
Practice Address - Country:US
Practice Address - Phone:714-771-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16768225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand