Provider Demographics
NPI:1023593530
Name:ABBOTT, DANA HARTEL (OTR/L)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:HARTEL
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:HARTEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7009 MARSH WREN ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3971
Mailing Address - Country:US
Mailing Address - Phone:949-351-3113
Mailing Address - Fax:
Practice Address - Street 1:1922 HACIENDA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6024
Practice Address - Country:US
Practice Address - Phone:760-295-4175
Practice Address - Fax:760-295-4176
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16997225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand