Provider Demographics
NPI:1952823908
Name:NEWSAM, MARIANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:NEWSAM
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 1:6605 W 80TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1166
Mailing Address - Country:US
Mailing Address - Phone:424-218-6884
Mailing Address - Fax:
Practice Address - Street 1:6605 W 80TH ST STE A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1166
Practice Address - Country:US
Practice Address - Phone:424-218-6884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5425225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics