Active NPI
Jessica Marie Baniqued Mateo, OTD, OTR/L
- Pediatric Occupational Therapist
- Irvine, CA
National Provider Identifier
1073495941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 515297
- Practice address
- 15265 Alton Pkwy Ste 140
Irvine, CA 92618-2605 - Phone
- (949) 835-3746
- NPI assigned
- Jul 22, 2025
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 515297 | Primary |
Addresses
Primary practice location
15265 Alton Pkwy Ste 140
Irvine, CA 92618-2605
Mailing address
2150 S State College Blvd Apt 4019
Anaheim, CA 92806-0141
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tumble N' Dots, Inc. | Pediatrics | Current | Accepting new patients |
Locations
15265 Alton Pkwy
Ste 140
Irvine, CA 92618
Phone (949) 835-3746
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": "1753142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753142400000",
"number": "1073495941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 S STATE COLLEGE BLVD APT 4019",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928060141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15265 ALTON PKWY STE 140",
"city": "IRVINE",
"state": "CA",
"postal_code": "926182605",
"telephone_number": "949-835-3746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEO",
"first_name": "JESSICA MARIE",
"middle_name": "BANIQUED",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-22",
"last_updated": "2025-07-22",
"certification_date": "2025-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": "515297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.