Provider Demographics
NPI:1730343948
Name:SALAZAR, TRICIA TAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:TAN
Last Name:SALAZAR
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 1:27145 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-2216
Mailing Address - Country:US
Mailing Address - Phone:310-377-4767
Mailing Address - Fax:
Practice Address - Street 1:27145 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-2216
Practice Address - Country:US
Practice Address - Phone:310-377-4767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3633225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist