Provider Demographics
NPI:1427793934
Name:MABAET, TRISHA MERCADO (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:TRISHA
Middle Name:MERCADO
Last Name:MABAET
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:MERCADO
Other - Last Name:MABAET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1600 N ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3722
Mailing Address - Country:US
Mailing Address - Phone:805-988-2500
Mailing Address - Fax:
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3722
Practice Address - Country:US
Practice Address - Phone:805-988-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23183225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist