Provider Demographics
NPI:1841906286
Name:AMIN, MAUSAMBEN (OTR/L)
Entity type:Individual
Prefix:
First Name:MAUSAMBEN
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4232 S HEATHER PRIVADO
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-2606
Mailing Address - Country:US
Mailing Address - Phone:714-272-5193
Mailing Address - Fax:
Practice Address - Street 1:4232 S HEATHER PRIVADO
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-2606
Practice Address - Country:US
Practice Address - Phone:714-272-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23417225X00000X
CAOT23417225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist