Provider Demographics
NPI:1124379235
Name:MOUSHEGIAN, JANICE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:MOUSHEGIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:L
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4209 S MONARCH WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3125
Mailing Address - Country:US
Mailing Address - Phone:310-367-7797
Mailing Address - Fax:
Practice Address - Street 1:2831 CEDARWOOD WAY
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-6842
Practice Address - Country:US
Practice Address - Phone:310-367-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT11925225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist