Provider Demographics
NPI:1093008609
Name:ADAMS, VALERIE SHANNON (OTR)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:SHANNON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 GAVIOTA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4328
Mailing Address - Country:US
Mailing Address - Phone:562-427-5300
Mailing Address - Fax:562-427-5300
Practice Address - Street 1:3735 GAVIOTA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4328
Practice Address - Country:US
Practice Address - Phone:562-427-5300
Practice Address - Fax:562-427-5300
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2649225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics