Provider Demographics
NPI:1740064161
Name:ELHAJJAOUI, NADEEN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:NADEEN
Middle Name:
Last Name:ELHAJJAOUI
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 SUMMERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:RCH CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-9228
Mailing Address - Country:US
Mailing Address - Phone:909-224-1883
Mailing Address - Fax:
Practice Address - Street 1:9900 INDIANA AVE STE 8
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5498
Practice Address - Country:US
Practice Address - Phone:951-376-1120
Practice Address - Fax:951-376-1182
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist