Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Nicolas Russell Mabardy, OTR

Individual provider Occupational Therapist · NPI 1912453374

Mr. Nicolas Russell Mabardy, OTR is an Occupational Therapist in Los Angeles, California. Licensed in California. Registered with an NPI since 2016.

Licensed in
CA
In the registry since
2016
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

1801 Malcolm Ave
Los Angeles, CA 90025-4729
Phone: (415) 847-2081
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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 OT16507 (CA)

Record details

NPI number1912453374
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR
Sole proprietorNo
NPI enumeratedAugust 26, 2016
Last updated in NPPESAugust 26, 2016

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