Individual provider · Type 1 NPI

Jordan Boediarto, COTA/L

Occupational Therapy Assistant · Anaheim, CA

NPI number 1508473737 Active

Practice location

141 S Knott Ave
Anaheim, CA 92804-1458

Call (714) 821-7310 Map

Mailing address

9362 Mayrene Dr
Garden Grove, CA 92841-4822

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X2553 (CA)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1508473737

Jordan Boediarto, COTA/L's National Provider Identifier is 1508473737, issued on Oct 1, 2020. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Anaheim, CA. The record was last updated on Oct 1, 2020.