Active NPI
Tamara Mangum, B.S. OCCUPATIONAL TH
- Pediatric Occupational Therapist
- Irvine, CA
National Provider Identifier
1023292299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 3995
- Practice address
- 1663 Noyes Ave
Irvine, CA 92606 - Phone
- (949) 252-9946
- NPI assigned
- Dec 24, 2007
- Last updated
- Dec 24, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 3995 | CA | Primary |
Addresses
Primary practice location
1663 Noyes Ave
Irvine, CA 92606
Mailing address
7 Villoria
Irvine, CA 92602-0938
Phone (714) 544-9309
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3995 | CA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Irvine Therapy Services, Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198454400000",
"number": "1023292299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 VILLORIA",
"city": "IRVINE",
"state": "CA",
"postal_code": "926020938",
"telephone_number": "714-544-9309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1663 NOYES AVE",
"city": "IRVINE",
"state": "CA",
"postal_code": "92606",
"telephone_number": "949-252-9946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUM",
"first_name": "TAMARA",
"credential": "B.S. OCCUPATIONAL TH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-24",
"last_updated": "2007-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "3995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.