Provider Demographics
NPI:1629489927
Name:HO, REBECCA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:HO
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 1:1311 VENICE BLVD
Mailing Address - Street 2:APT 6
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-5080
Mailing Address - Country:US
Mailing Address - Phone:650-504-6638
Mailing Address - Fax:
Practice Address - Street 1:1311 VENICE BLVD
Practice Address - Street 2:APT 6
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-5080
Practice Address - Country:US
Practice Address - Phone:650-504-6638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12715225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist