Individual provider Active NPI

Patrice Annie Udo, OTD

  • Occupational Therapist
  • San Bernardino, CA
National Provider Identifier
1053928291
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
438578 Issued in CA
Practice address
1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434
Phone
(909) 890-9030
Fax
(909) 890-4393
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 438578 CA Primary

Addresses

Primary practice location

1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434

Mailing address

1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434
Phone (909) 890-9030

Other practice location 1

3700 E Tachevah Dr Ste 107
Palm Springs, CA 92262-7402
Phone (760) 459-0003

Other practice location 2

802 Magnolia Ave Ste 107
Corona, CA 92879-3125
Phone (951) 340-0070

Other practice location 3

3400 Central Ave Ste 145
Riverside, CA 92506-2161
Phone (951) 297-3399

Other practice location 4

46900 Monroe St Bldg C Ste 304
Indio, CA 92201-4829
Phone (760) 289-3010

Other practice location 5

100 N Barranca St Ste 380
West Covina, CA 91791-1623
Phone (626) 331-8355

Other practice location 6

10470 Foothill Blvd Ste 101
Rancho Cucamonga, CA 91730-3754
Phone (909) 948-0411

Other identifiers 1

IdentifierTypeStateIssuer
1053928291MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210506002848 CA Practitioner - Occupational Therapist in Private Practice 9335558113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Therapy Network IncorporatedGroup PAC ID 9234022369, 22 clinicians

Practice addresses (Care Compare)

3400 Central Ave
Suite 145
Riverside, CA 92506-2161
Phone (909) 890-9030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
438578CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Therapy Network Incorporated Occupational Therapist Current Accepting new patients
Map Healthcare Occupational Therapist Current Accepting new patients
United Therapy Network Incorporated Occupational Therapist CurrentSince Mar 23, 2021 Accepting new patients
United Therapy Network Incorporated Occupational Therapist CurrentSince Mar 23, 2021 Accepting new patients
Kimberly J Evans Otr L CHT Professional Corporation Occupational Therapist PastSince Oct 1, 2020 Accepting new patients
Kimberly J Evans Otr L CHT Professional Corporation Occupational Therapist PastSince Oct 1, 2020 Accepting new patients

Locations

802 Magnolia Ave
Ste 107
Corona, CA 92879
Phone (951) 340-0070

1902 Royalty Dr
Ste 220
Pomona, CA 91767
Phone (909) 570-3108

3400 Central Ave
Ste 145
Riverside, CA 92506
Phone (951) 297-3399

1845 Business Center Dr
Ste 127
Sn Bernrdno, CA 92408
Phone (909) 890-9030

100 N Barranca St
Ste 380
West Covina, CA 91791
Phone (626) 331-8355

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1053928291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 E Tachevah Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922627402",
            "country_code": "US",
            "telephone_number": "760-459-0003",
            "fax_number": "760-656-0614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "802 Magnolia Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928793125",
            "country_code": "US",
            "telephone_number": "951-340-0070",
            "fax_number": "951-340-9188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Central Ave Ste 145",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062161",
            "country_code": "US",
            "telephone_number": "951-297-3399",
            "fax_number": "951-297-3404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46900 Monroe St  Bldg C Ste 304",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922014829",
            "country_code": "US",
            "telephone_number": "760-289-3010",
            "fax_number": "760-863-1871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N Barranca St Ste 380",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917911623",
            "country_code": "US",
            "telephone_number": "626-331-8355",
            "fax_number": "626-331-8165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10470 Foothill Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303754",
            "country_code": "US",
            "telephone_number": "909-948-0411",
            "fax_number": "909-948-0511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDO",
        "first_name": "PATRICE",
        "middle_name": "ANNIE",
        "name_prefix": "Ms.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "438578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053928291",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.