DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ANOCHA SUPHOL, MPT

Active

ANOCHA SUPHOL, MPT is a Environmental Modification (OT) healthcare provider located in RIVERSIDE, California. NPI 1003031899 is currently active in the NPPES registry. Verify at CMS.

Environmental Modification (OT) · RIVERSIDE, CA

Registration Details

NPI Number
1003031899
Provider Type
Individual
Gender
Male
NPI Issued
Apr 16, 2007 (19.340469430768 yrs)
Last Updated
Sep 11, 2025
Licenses
PT27871 (CA)
PT27871 (CA)

Practice Information

Address
4444 MAGNOLIA AVE
RIVERSIDE, CA, 925014136
Browse CA providers · Browse ZIP 92501
Phone
9512743524
Fax
9512743442
Primary Specialty
Environmental Modification (OT)
2251S0007X

Other Environmental Modification (OT) Providers in RIVERSIDE, CA

Name Credential NPI
KIM SAMOSKY MPT, OCS, ATC 1639394414
BRENT HARPER DPT, OCS, CSCS 1902024169
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.