Provider Demographics
NPI:1467906974
Name:WEBB, VERONICA MARIE (MA, OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:MARIE
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4906
Mailing Address - Country:US
Mailing Address - Phone:310-956-7464
Mailing Address - Fax:
Practice Address - Street 1:811 N CATALINA AVE STE 1300
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2190
Practice Address - Country:US
Practice Address - Phone:310-673-8412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA18278225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program