Provider Demographics
NPI:1740723295
Name:MUSSLY, KARLA (OTA/L)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:MUSSLY
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26681 AVENIDA LAS PALMAS # A
Mailing Address - Street 2:
Mailing Address - City:CAPO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1451
Mailing Address - Country:US
Mailing Address - Phone:949-289-2502
Mailing Address - Fax:
Practice Address - Street 1:24962 CALLE ARAGON
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3883
Practice Address - Country:US
Practice Address - Phone:949-587-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1547224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant