Provider Demographics
NPI:1770555302
Name:RICKER, DEBRA RAE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:RAE
Last Name:RICKER
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 1:3572 THOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3969
Mailing Address - Country:US
Mailing Address - Phone:562-760-1400
Mailing Address - Fax:562-799-9926
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3144
Practice Address - Country:US
Practice Address - Phone:562-760-1400
Practice Address - Fax:562-799-9926
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT2301225XH1300X, 225XN1300X, 225XR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Not Answered225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community Mobility