Active NPI
Lacey L Tygenhof, OTR/L
- Occupational Therapist
- Fullerton, CA
National Provider Identifier
1841636610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13830
- Practice address
- 1400 N Harbor Blvd Ste 300
Fullerton, CA 92835-4145 - Phone
- (714) 870-5970
- NPI assigned
- May 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13830 | CA | Primary |
Addresses
Primary practice location
1400 N Harbor Blvd Ste 300
Fullerton, CA 92835-4145
Mailing address
1400 N Harbor Blvd Ste 300
Fullerton, CA 92835-4145
Phone (714) 870-5970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1841636610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N HARBOR BLVD STE 300",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928354145",
"telephone_number": "714-870-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N HARBOR BLVD STE 300",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928354145",
"telephone_number": "714-870-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYGENHOF",
"first_name": "LACEY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-20",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "CA",
"license": "13830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.