Provider Demographics
NPI:1427476183
Name:SHERRIE, LORRAINE ANN (COTA/C)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:ANN
Last Name:SHERRIE
Suffix:
Gender:F
Credentials:COTA/C
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:SHERRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:24242 LA CRESTA
Mailing Address - Street 2:OT DEPARTMENT
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629
Mailing Address - Country:US
Mailing Address - Phone:949-743-4059
Mailing Address - Fax:949-234-0349
Practice Address - Street 1:24242 LA CRESTA
Practice Address - Street 2:OT DEPARTMENT
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629
Practice Address - Country:US
Practice Address - Phone:949-743-4059
Practice Address - Fax:949-234-0349
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1690224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant