Staci L Raygoza, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA 1233 Issued in CA

Practice address

17318 San Luis St.. #3
Fountain Valley, CA 92708

Phone

(714) 963-3770

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043431950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17318 SAN LUIS ST.. #3",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-963-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17318 SAN LUIS ST.. #3",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-963-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYGOZA",
        "first_name": "STACI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA 1233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ranjan K Sapra M.D a Medical Corporation
• Amol Rajeev Rao, M.D.
• Anas Raowas, M.D.
• Russell Paul Rapoza, M.D.
• Sean C. Rathan, MFT
• Julieann O. Rayos
• Jeanette Razo-Gonzalez
• Real Hope Marriage and Family Therapy, Inc.
• Al Pete Reaves
• Daniel E Recalde, DPM

• Occupational Therapy Assistant in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.