Susie Park, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

22451 Issued in CA

Practice address

19772 Macarthur Blvd Ste 260a
Irvine, CA 92612-2413

Phone

(949) 474-4525

NPI assigned

Jun 15, 2021

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1922676923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19772 MACARTHUR BLVD STE 260A",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122413",
            "telephone_number": "949-474-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19772 MACARTHUR BLVD STE 260A",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122413",
            "telephone_number": "949-474-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "22451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Park
• SE J Park, NP-C, DNP
• So Y Park, L.AC.
• Sunmin Park
• Susan Lee Park, NP, L AC
• Tony J Park, PHARM.D., J.D.
• Unice Park
• Victor S Park
• Wonsang Park
• Yejin Park

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.