Provider Demographics
NPI:1639473697
Name:CAULEY, MEGAN DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DENISE
Last Name:CAULEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:DENISE
Other - Last Name:MALIZIOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:552 CYPRESS DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1575
Mailing Address - Country:US
Mailing Address - Phone:415-378-9567
Mailing Address - Fax:
Practice Address - Street 1:552 CYPRESS DR
Practice Address - Street 2:UNIT B
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1575
Practice Address - Country:US
Practice Address - Phone:415-378-9567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist