Provider Demographics
NPI:1558920942
Name:LENTZ, CECILIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:LENTZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23531 PORTER CIR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4631
Mailing Address - Country:US
Mailing Address - Phone:909-234-0511
Mailing Address - Fax:
Practice Address - Street 1:23531 PORTER CIR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4631
Practice Address - Country:US
Practice Address - Phone:909-234-0511
Practice Address - Fax:866-657-7667
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT16185225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist