Provider Demographics
NPI:1194431874
Name:LOEFFLER, VICTORIA ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSE
Last Name:LOEFFLER
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 1:31560 AGOURA RD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4413
Mailing Address - Country:US
Mailing Address - Phone:818-877-6403
Mailing Address - Fax:
Practice Address - Street 1:401 RONEL CT
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-3664
Practice Address - Country:US
Practice Address - Phone:805-375-9078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007797225X00000X
CA24604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist