Provider Demographics
NPI:1639660236
Name:DINH, TRICIA NGOC-DIEM (OTR/L)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:NGOC-DIEM
Last Name:DINH
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 1:9891 FARNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2268
Mailing Address - Country:US
Mailing Address - Phone:714-425-8844
Mailing Address - Fax:
Practice Address - Street 1:9891 FARNHAM AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2268
Practice Address - Country:US
Practice Address - Phone:714-425-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12054225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist