Provider Demographics
NPI:1942468251
Name:NAVARRO, LARRY DEAN (COTA/C)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:DEAN
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:COTA/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W WARDLOW RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4429
Mailing Address - Country:US
Mailing Address - Phone:562-988-8031
Mailing Address - Fax:
Practice Address - Street 1:200 W WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4429
Practice Address - Country:US
Practice Address - Phone:562-988-8031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA454224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant