Provider Demographics
NPI:1568344976
Name:WARDLAW, ADRIENNE HUFF (COTA/L)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:HUFF
Last Name:WARDLAW
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26316 LOS VIVEROS APT E
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2877
Mailing Address - Country:US
Mailing Address - Phone:714-262-8924
Mailing Address - Fax:
Practice Address - Street 1:15265 ALTON PKWY STE 140
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2605
Practice Address - Country:US
Practice Address - Phone:949-835-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484648224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant