Provider Demographics
NPI:1376861435
Name:TREWIN, AUDREY L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:L
Last Name:TREWIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 S HELBERTA AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5129
Mailing Address - Country:US
Mailing Address - Phone:650-704-8123
Mailing Address - Fax:
Practice Address - Street 1:21615 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6670
Practice Address - Country:US
Practice Address - Phone:310-371-8555
Practice Address - Fax:310-371-4488
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5790225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics