Search › California › 224Z00000X
Michael Derose, COTA/L
NPI 1417581646 · on the registry since 2020 · sole proprietor
Practice
- Address
- 1200 Quail St Ste 100
Newport Beach, CA 92660 - Phone
- (949) 475-1002
- Organisation at this address
- Silverspoon Nutrition
Olivia Carr Family Therapy Professional CorporationInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Additional practice sites
- 17 Riptide Ct, Newport Beach, CA
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-02-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California