Active NPI
Bhavna Shukla, OTR
- Pediatric Occupational Therapist
- Rancho Cucamonga, CA
National Provider Identifier
1003980087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT27368
- Practice address
- 8265 White Oak Ave
Rancho Cucamonga, CA 91730 - Phone
- (909) 373-1641
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT27368 | CA | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 056007791 | IL |
Addresses
Primary practice location
8265 White Oak Ave
Rancho Cucamonga, CA 91730
Mailing address
856 W Nelson St
# 1106
Chicago, IL 60657-5152
Phone (773) 746-2463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700307663 | Medicaid | CA |
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 |
|---|---|---|---|
| 056007791 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003980087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "856 W NELSON ST",
"address_2": "# 1106",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575152",
"telephone_number": "773-746-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8265 WHITE OAK AVE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "91730",
"telephone_number": "909-373-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKLA",
"first_name": "BHAVNA",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "OT27368",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056007791",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "700307663",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.