Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Therese Etayeb, OTR

Individual provider Hand Occupational Therapist · NPI 1790982858

Mary Therese Etayeb, OTR is an Occupational Therapist in Private Practice in Los Angeles, California. Qualified in 1986, 40 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
40
Licensed in
CA
In the registry since
2007
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone: (323) 857-2536
Fax: (323) 857-3736
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hand Occupational Therapist (primary) Taxonomy 225XH1200X · Licence 5942 (CA)

Record details

NPI number1790982858
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR
Sole proprietorNo
NPI enumeratedJune 29, 2007
Last updated in NPPESDecember 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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