Active NPI
Justin A Parnell
- Occupational Therapist
- Gardena, CA
National Provider Identifier
1003482613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 24461
- Practice address
- 108 W Victoria St
Gardena, CA 90248-3523 - Phone
- (310) 715-2020
- NPI assigned
- Jun 3, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10318 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Occupational Therapist | 225X00000X | 24461 | CA | Primary |
Addresses
Primary practice location
108 W Victoria St
Gardena, CA 90248-3523
Mailing address
6337 Halstead Ave
Rancho Cucamonga, CA 91737-3750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10318 | CA | MD | Optometrist |
| 24461 | CA | MD | Homeopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1003482613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6337 HALSTEAD AVE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917373750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-715-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARNELL",
"first_name": "JUSTIN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-03",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "10318",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "24461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.