Rondelle J Bake, OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Cypress, CA

NPI 1508092792 · NPPES record last updated Aug 7, 2012

Key facts

NPI
1508092792
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
OT10512 (CA)
Practice address
11105 Knott Ave
Suite a
Cypress, CA 90630-5137
Phone
(714) 893-7399
Fax
(714) 893-7389
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
OT10512CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pediatric Physical Therapy, Inc Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT10512 CA Yes

Addresses

Primary practice location

11105 Knott Ave
Suite a
Cypress, CA 90630-5137

Mailing address

11105 Knott Ave
Suite a
Cypress, CA 90630-5137
Phone (714) 893-7399

Other providers in Cypress, CA

All providers in Cypress, CA · Pediatric Occupational Therapist in California

Sources for this page

Verify at the official NPI Registry.