Provider Demographics
NPI:1710462205
Name:NAIR, NETRA MOHAN (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:NETRA
Middle Name:MOHAN
Last Name:NAIR
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39933 BANYAN ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4333
Mailing Address - Country:US
Mailing Address - Phone:213-425-9307
Mailing Address - Fax:
Practice Address - Street 1:41870 MCALBY CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7036
Practice Address - Country:US
Practice Address - Phone:951-696-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16688225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist