Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Boediarto, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1508473737

Jordan Boediarto, COTA/L is an Occupational Therapy Assistant in Anaheim, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

141 S Knott Ave
Anaheim, CA 92804-1458
Phone: (714) 821-7310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 2553 (CA)

Record details

NPI number1508473737
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorYes
NPI enumeratedOctober 1, 2020
Last updated in NPPESOctober 1, 2020
Certification dateOctober 1, 2020

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