Provider Demographics
NPI:1467827584
Name:BUZZETTA, ALLISON MAUREEN (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MAUREEN
Last Name:BUZZETTA
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N TUSTIN AVE APT B9
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1645
Mailing Address - Country:US
Mailing Address - Phone:570-762-2978
Mailing Address - Fax:
Practice Address - Street 1:292 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3330
Practice Address - Country:US
Practice Address - Phone:310-954-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15825225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist