Provider Demographics
NPI:1750476701
Name:SIEGEL, RONNA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:RONNA
Middle Name:
Last Name:SIEGEL
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 1:15449 WYANDOTTE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3334
Mailing Address - Country:US
Mailing Address - Phone:818-787-4922
Mailing Address - Fax:
Practice Address - Street 1:25050 PEACHLAND AVE STE 203
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-5769
Practice Address - Country:US
Practice Address - Phone:661-222-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6202225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist