Individual provider Active NPI

Wendy Aquino Castro

  • Occupational Therapy Assistant
  • Garden Grove, CA
National Provider Identifier
1053951947
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5117 Issued in CA
Practice address
12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027
Phone
(714) 750-9700
Fax
(714) 750-9797
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5117 CA Primary

Addresses

Primary practice location

12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027

Mailing address

PO Box 1726
Westminster, CA 92684-1726
Phone (714) 750-9700

Other practice location 1

8135 Painter Ave Ste 200
Whittier, CA 90602-3168
Phone (562) 698-6600

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

State licenses

LicenseStateTypeSpecialty
5117CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Fundamentals Therapy Center, Inc. CurrentSince Jan 8, 2023 Accepting new patients

Locations

12900B Garden Grove Blvd
Ste 235
Garden Grove, CA 92843
Phone (714) 750-9700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1053951947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1726",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926841726",
            "telephone_number": "714-750-9700",
            "fax_number": "714-750-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900B GARDEN GROVE BLVD STE 235",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432027",
            "telephone_number": "714-750-9700",
            "fax_number": "714-750-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8135 Painter Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906023168",
            "country_code": "US",
            "telephone_number": "562-698-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AQUINO CASTRO",
        "first_name": "WENDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.