Provider Demographics
NPI:1508451626
Name:BUSBY, ERICA (COTA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BUSBY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1056
Mailing Address - Country:US
Mailing Address - Phone:805-421-8597
Mailing Address - Fax:
Practice Address - Street 1:4020 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1801
Practice Address - Country:US
Practice Address - Phone:805-642-4196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant