Active NPI
Mariella Ysobel Romero Timbang, OTR/L
- Occupational Therapist
- Fullerton, CA
National Provider Identifier
1023617248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 21668
- Practice address
- 423 Imperial Hwy
Fullerton, CA 92835-1146 - Phone
- (714) 465-4777
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 21668 | CA | Primary |
Addresses
Primary practice location
423 Imperial Hwy
Fullerton, CA 92835-1146
Mailing address
423 Imperial Hwy
Fullerton, CA 92835-1146
Phone (714) 465-4777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210810003091 | CA | Practitioner - Occupational Therapist in Private Practice | 9133523319 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21668 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756252800000",
"number": "1023617248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 IMPERIAL HWY",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928351146",
"telephone_number": "714-465-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 IMPERIAL HWY",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928351146",
"telephone_number": "714-465-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMBANG",
"first_name": "MARIELLA YSOBEL",
"middle_name": "ROMERO",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-19",
"last_updated": "2025-08-27",
"certification_date": "2025-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "21668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.