Provider Demographics
NPI:1811016926
Name:UKLEJA, AMY KRISTIN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KRISTIN
Last Name:UKLEJA
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:KRISTIN
Other - Last Name:BROWNFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2515 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-1106
Mailing Address - Country:US
Mailing Address - Phone:562-857-4492
Mailing Address - Fax:
Practice Address - Street 1:19772 MACARTHUR BLVD STE 260A
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2413
Practice Address - Country:US
Practice Address - Phone:949-474-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8724225XP0200X, 225X00000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist