Provider Demographics
NPI:1689302010
Name:CEDARBAUM, ESTHER N (MSOT)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:N
Last Name:CEDARBAUM
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:MS
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:LAVI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:15134 MOORPARK ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONR REHAB AT VALLEY VISTA SENIOR LIVING
Practice Address - Street 2:7040 VAN NUYS BLVD
Practice Address - City:VAN N UYS
Practice Address - State:CA
Practice Address - Zip Code:91404
Practice Address - Country:US
Practice Address - Phone:800-967-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12169225XG0600X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology