Provider Demographics
NPI:1871110064
Name:ESPERO, BREANNA CAMBARE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:CAMBARE
Last Name:ESPERO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7844 E DEERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-6523
Mailing Address - Country:US
Mailing Address - Phone:714-507-8400
Mailing Address - Fax:
Practice Address - Street 1:1815 W 213TH ST STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2852
Practice Address - Country:US
Practice Address - Phone:310-328-0276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist