Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellen Park, MS, OTR/L

Individual provider Occupational Therapist · NPI 1619475043

Ellen Park, MS, OTR/L is an Occupational Therapist in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
What do these letters mean?
MS — Master of Science
A graduate science degree.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone: (858) 552-8585
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 17788 (CA)

Record details

NPI number1619475043
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , OTR/L
Sole proprietorYes
NPI enumeratedJanuary 31, 2018
Last updated in NPPESJuly 22, 2020
Certification dateJuly 22, 2020

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