Provider Demographics
NPI:1881439784
Name:MAJOR, RANDI J (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:J
Last Name:MAJOR
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 1:24055 CLINTON KEITH RD APT 1103
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-8608
Mailing Address - Country:US
Mailing Address - Phone:661-565-6443
Mailing Address - Fax:
Practice Address - Street 1:25467 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-1501
Practice Address - Country:US
Practice Address - Phone:951-899-0204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26555225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty