Provider Demographics
NPI:1043508062
Name:PLUSKALOWSKI, ELIZABETH KATZ (MS OTR/L, SWC, IBCLC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATZ
Last Name:PLUSKALOWSKI
Suffix:
Gender:F
Credentials:MS OTR/L, SWC, IBCLC
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Other - Middle Name:
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Mailing Address - Street 1:22231 HAZEL CRST
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1086
Mailing Address - Country:US
Mailing Address - Phone:914-552-7039
Mailing Address - Fax:
Practice Address - Street 1:22231 HAZEL CRST
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1086
Practice Address - Country:US
Practice Address - Phone:914-552-7039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-311415174N00000X
CA15828225XF0002X, 225XP0200X
VA0119005418225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing