Provider Demographics
NPI:1215510300
Name:NODA, ELYSE (OTR/L)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:NODA
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 1:2641 HAMNER AVE
Mailing Address - Street 2:UNIT 102, 106, 110
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860
Mailing Address - Country:US
Mailing Address - Phone:626-536-4834
Mailing Address - Fax:
Practice Address - Street 1:2641 HAMNER AVE
Practice Address - Street 2:UNIT 102, 106, 110
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860
Practice Address - Country:US
Practice Address - Phone:626-536-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist