Provider Demographics
NPI:1376778928
Name:VILLAR, IRENE (PHD, OTR/L, SWC)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:VILLAR
Suffix:
Gender:F
Credentials:PHD, OTR/L, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E FOOTHILL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2314
Mailing Address - Country:US
Mailing Address - Phone:626-445-2400
Mailing Address - Fax:626-445-2419
Practice Address - Street 1:50 E FOOTHILL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2314
Practice Address - Country:US
Practice Address - Phone:626-445-2400
Practice Address - Fax:626-445-2419
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1509225XP0200X, 225XF0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing