Susana Morell Dornberg, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 4667 Issued in CA

Practice address

2040 Pacific Coast Hwy
Lomita, CA 90717-2660

Phone

(310) 920-2302

NPI assigned

May 21, 2007

Last updated

Dec 7, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1053520924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 VIA LA SOLEDAD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776626",
            "telephone_number": "310-920-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 PACIFIC COAST HWY",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172660",
            "telephone_number": "310-920-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBERG",
        "first_name": "SUSANA",
        "middle_name": "MORELL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 4667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Lomita, CA
• Providers in Lomita, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.