Provider Demographics
NPI:1528268778
Name:BEDUYA, MARION ANTONETTE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:ANTONETTE
Last Name:BEDUYA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:MARION
Other - Middle Name:ANTONETTE
Other - Last Name:BEDUYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11429 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3143
Mailing Address - Country:US
Mailing Address - Phone:818-766-9551
Mailing Address - Fax:818-508-1838
Practice Address - Street 1:11429 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3143
Practice Address - Country:US
Practice Address - Phone:818-766-9551
Practice Address - Fax:818-508-3818
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7920225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist