Active NPI
Britt E Wallstrom, OT
- Occupational Therapist
- Riverside, CA
National Provider Identifier
1043788904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 18800
- Practice address
- 6177 River Crest Dr Ste a
Riverside, CA 92507-0728 - Phone
- (951) 653-4480
- Fax
- (951) 653-5051
- NPI assigned
- Nov 8, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 18800 | CA | Primary |
Addresses
Primary practice location
6177 River Crest Dr Ste a
Riverside, CA 92507-0728
Mailing address
6177 River Crest Dr Ste a
Riverside, CA 92507-0728
Phone (951) 653-4480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18800 | Other | CA | OT LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18800 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feld Care Therapy Inc | Occupational Therapist | Past | Accepting new patients |
| West Coast Spine Restoration Center, Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Riverside, CA
- NPI 1992887616
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1043788904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6177 RIVER CREST DR STE A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070728",
"telephone_number": "951-653-4480",
"fax_number": "951-653-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6177 RIVER CREST DR STE A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070728",
"telephone_number": "951-653-4480",
"fax_number": "951-653-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLSTROM",
"first_name": "BRITT",
"middle_name": "E",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-08",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "18800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OT LICENSE",
"identifier": "18800",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.