Provider Demographics
NPI:1801299565
Name:BLOCK, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BLOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 NEWPORT CENTER DR STE 213
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7503
Mailing Address - Country:US
Mailing Address - Phone:949-644-0316
Mailing Address - Fax:
Practice Address - Street 1:26302 LA PAZ RD STE 105
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5327
Practice Address - Country:US
Practice Address - Phone:949-206-1700
Practice Address - Fax:949-206-1800
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist