Provider Demographics
NPI:1558604199
Name:CRUZ, TAMMY LYN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LYN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 N RICE AVE
Mailing Address - Street 2:170/180
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030
Mailing Address - Country:US
Mailing Address - Phone:805-826-9000
Mailing Address - Fax:805-830-1777
Practice Address - Street 1:3418 LOMA VISTA RD
Practice Address - Street 2:SUITE A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3016
Practice Address - Country:US
Practice Address - Phone:805-765-4773
Practice Address - Fax:805-258-7039
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1597225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist