Provider Demographics
NPI:1336209089
Name:AHN, EMY REIKO TOME (OTR)
Entity Type:Individual
Prefix:
First Name:EMY
Middle Name:REIKO TOME
Last Name:AHN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:EMY
Other - Middle Name:REIKO
Other - Last Name:TOME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:14 PERKINS CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-4043
Mailing Address - Country:US
Mailing Address - Phone:909-896-1633
Mailing Address - Fax:
Practice Address - Street 1:24171 PAVION
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-2200
Practice Address - Country:US
Practice Address - Phone:949-707-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7275225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist