Provider Demographics
NPI:1396758363
Name:PATERSON, MARTHA H (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:H
Last Name:PATERSON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 W MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 710
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2818
Mailing Address - Country:US
Mailing Address - Phone:818-955-8303
Mailing Address - Fax:818-465-4606
Practice Address - Street 1:2211 W MAGNOLIA BLVD STE 295
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1753
Practice Address - Country:US
Practice Address - Phone:818-955-8303
Practice Address - Fax:818-465-4606
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91-6242225XE1200X, 225XN1300X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OT5293Medicare UPIN
CAN5293Medicare PIN