Provider Demographics
NPI:1821677360
Name:MORENO-SAENZ, ADELA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ADELA
Middle Name:
Last Name:MORENO-SAENZ
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 1:114 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-2824
Mailing Address - Country:US
Mailing Address - Phone:310-683-8047
Mailing Address - Fax:
Practice Address - Street 1:632 W 11TH ST STE 119
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3860
Practice Address - Country:US
Practice Address - Phone:209-237-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist