Michelle Ely Ricardo, MOTR

Individual provider Active NPI Occupational Therapist · Lake Arrowhead, CA

NPI 1427259795 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1427259795
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT1391 (CA)
Practice address
29099 Hospital Road
106
Lake Arrowhead, CA 92352
Phone
(909) 337-0844
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT1391CAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1391 CA Yes

Addresses

Primary practice location

29099 Hospital Road
106
Lake Arrowhead, CA 92352

Mailing address

29099 Hospital Road
106
Lake Arrowhead, CA 92352
Phone (909) 337-0844

Other providers in Lake Arrowhead, CA

All providers in Lake Arrowhead, CA · Occupational Therapist in California

Sources for this page

Verify at the official NPI Registry.