Provider Demographics
NPI:1588249759
Name:SCHWARTZ, SUZIE (OTR/L, MOT)
Entity type:Individual
Prefix:
First Name:SUZIE
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:OTR/L, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MOCKINGBIRD LN APT D
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2002
Mailing Address - Country:US
Mailing Address - Phone:909-801-1495
Mailing Address - Fax:
Practice Address - Street 1:300 MOCKINGBIRD LN APT D
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2002
Practice Address - Country:US
Practice Address - Phone:909-801-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10713225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist