Provider Demographics
NPI:1548809726
Name:TALAVERA-KLEKAR, RICHARD ALLEN (OTR/L)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLEN
Last Name:TALAVERA-KLEKAR
Suffix:
Gender:M
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 1:9550 NADINE ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3146
Mailing Address - Country:US
Mailing Address - Phone:626-349-8188
Mailing Address - Fax:
Practice Address - Street 1:273 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3775
Practice Address - Country:US
Practice Address - Phone:323-724-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist