Provider Demographics
NPI:1407534639
Name:NIELSON, ANDREA MARIE (OTD, OTR/L, CNS,CSRS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:NIELSON
Suffix:
Gender:F
Credentials:OTD, OTR/L, CNS,CSRS
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:HEINRICHS NIELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR/L, CNS,CSRS
Mailing Address - Street 1:74773 GARY AVE
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2023
Mailing Address - Country:US
Mailing Address - Phone:760-851-8878
Mailing Address - Fax:
Practice Address - Street 1:44600 MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3323
Practice Address - Country:US
Practice Address - Phone:760-851-8878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT11360225XN1300X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation