Provider Demographics
NPI:1134179724
Name:DEWHIRST, AUDREY (OTR/L/CHT, HTC, PAM)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:
Last Name:DEWHIRST
Suffix:
Gender:F
Credentials:OTR/L/CHT, HTC, PAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19000 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1517
Mailing Address - Country:US
Mailing Address - Phone:310-371-5111
Mailing Address - Fax:310-371-8528
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1517
Practice Address - Country:US
Practice Address - Phone:310-371-5111
Practice Address - Fax:310-371-8528
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3427225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand