Provider Demographics
NPI:1821243528
Name:DEMUTH, ANN C (OTR)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:DEMUTH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26639 VALLEY CENTER DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-2357
Mailing Address - Country:US
Mailing Address - Phone:661-254-1842
Mailing Address - Fax:661-254-1862
Practice Address - Street 1:26639 VALLEY CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-2357
Practice Address - Country:US
Practice Address - Phone:661-254-1842
Practice Address - Fax:661-254-1862
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 5929225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist