Provider Demographics
NPI:1033865829
Name:BAUMGARTNER, ALEXANDRA RAE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:RAE
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4818 DARIEN ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-2055
Mailing Address - Country:US
Mailing Address - Phone:310-381-9360
Mailing Address - Fax:
Practice Address - Street 1:201 N CRESCENT DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4898
Practice Address - Country:US
Practice Address - Phone:310-274-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23350225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist