Provider Demographics
NPI:1821320862
Name:CARRINGTON, ANDRE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:
Last Name:CARRINGTON
Suffix:
Gender:M
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 1:7851 LA MONICA ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-6358
Mailing Address - Country:US
Mailing Address - Phone:909-798-7824
Mailing Address - Fax:909-798-7824
Practice Address - Street 1:7851 LA MONICA ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-6358
Practice Address - Country:US
Practice Address - Phone:909-798-7824
Practice Address - Fax:909-798-7824
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3989225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist