Provider Demographics
NPI:1497069744
Name:TRAUTMAN, SUSAN (OTD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:TRAUTMAN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:TRAUTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:2555 E COLORADO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6617
Mailing Address - Country:US
Mailing Address - Phone:626-564-2700
Mailing Address - Fax:
Practice Address - Street 1:2555 E COLORADO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6617
Practice Address - Country:US
Practice Address - Phone:626-564-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist