Provider Demographics
NPI:1275212953
Name:NG, ANNIE MOOI KIANG (OTR)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MOOI KIANG
Last Name:NG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 STRASSNER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1872
Mailing Address - Country:US
Mailing Address - Phone:844-502-7996
Mailing Address - Fax:
Practice Address - Street 1:11588 VIA RANCHO SAN DIEGO
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-5277
Practice Address - Country:US
Practice Address - Phone:619-416-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2529225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist