Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Samantha Nugroho, OTD, OTR/L

Individual provider Occupational Therapist · NPI 1720992373

Samantha Nugroho, OTD, OTR/L is an Occupational Therapist in Los Angeles, California. Licensed in California. Registered with an NPI since 2026.

Licensed in
CA
In the registry since
2026
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
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

12121 Wilshire Blvd Ste 206
Los Angeles, CA 90025-1176
Phone: (310) 709-3006
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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 29597 (CA)

Record details

NPI number1720992373
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTD , OTR/L
Sole proprietorNo
NPI enumeratedSeptember 30, 2026
Last updated in NPPESSeptember 30, 2026
Certification dateSeptember 30, 2026

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