Provider Demographics
NPI:1114757051
Name:MARKFIELD, FELICIA NICOLE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:NICOLE
Last Name:MARKFIELD
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 1:410 HAUSER BLVD APT 1C
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5488
Mailing Address - Country:US
Mailing Address - Phone:831-801-4529
Mailing Address - Fax:
Practice Address - Street 1:410 HAUSER BLVD APT 1C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5488
Practice Address - Country:US
Practice Address - Phone:831-801-4529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25843225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist