Provider Demographics
NPI:1467406785
Name:FERRARO, GRACE KATHRYN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:KATHRYN
Last Name:FERRARO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:KATHRYN
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:586 LAS PALMAS DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2315
Mailing Address - Country:US
Mailing Address - Phone:562-355-1556
Mailing Address - Fax:
Practice Address - Street 1:13601 BROWNING AVE
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-5212
Practice Address - Country:US
Practice Address - Phone:714-832-4685
Practice Address - Fax:714-573-4562
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 8212225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics