Provider Demographics
NPI:1629548573
Name:AIKEN, REBECCA FAITH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:FAITH
Last Name:AIKEN
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 1:26142 SERRANO CT UNIT 21
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-6440
Mailing Address - Country:US
Mailing Address - Phone:248-701-6908
Mailing Address - Fax:
Practice Address - Street 1:26142 SERRANO CT UNIT 21
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-6440
Practice Address - Country:US
Practice Address - Phone:949-534-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18244225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist