Provider Demographics
NPI:1710422449
Name:HOVEY, DOUGLAS (OTR/L)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:HOVEY
Suffix:
Gender:M
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 1:927 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-2103
Mailing Address - Country:US
Mailing Address - Phone:310-625-7688
Mailing Address - Fax:
Practice Address - Street 1:927 23RD ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2103
Practice Address - Country:US
Practice Address - Phone:310-625-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16897225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist