Provider Demographics
NPI:1720018476
Name:GUITERAS, LISA ANN (OTR/L, CHT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:GUITERAS
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 RALSTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7844
Mailing Address - Country:US
Mailing Address - Phone:805-804-4168
Mailing Address - Fax:805-830-1177
Practice Address - Street 1:137 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5707
Practice Address - Country:US
Practice Address - Phone:805-379-2132
Practice Address - Fax:805-917-4206
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 4720225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4720OtherSTATE LICENSE
CAAV879OtherMEDICARE PROVIDER
CAAV879OtherMEDICARE PROVIDER