Active NPI
Michelle C. Bronner, OTR/L
- Occupational Therapist
- Irvine, CA
National Provider Identifier
1073854568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 9591
- Practice address
- 65 Long MDW
Irvine, CA 92620-2825 - Phone
- (949) 394-6587
- NPI assigned
- Mar 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | OT 9591 | CA | Primary |
Addresses
Primary practice location
65 Long MDW
Irvine, CA 92620-2825
Mailing address
17595 Harvard Ave Ste C2230
Irvine, CA 92614-8516
Phone (949) 394-6587
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 |
|---|---|---|---|
| 9591 | CA | MD | Physical Therapy Assistant |
| OT 9591 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533686400000",
"number": "1073854568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17595 HARVARD AVE STE C2230",
"city": "IRVINE",
"state": "CA",
"postal_code": "926148516",
"telephone_number": "949-394-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 LONG MDW",
"city": "IRVINE",
"state": "CA",
"postal_code": "926202825",
"telephone_number": "949-394-6587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONNER",
"first_name": "MICHELLE",
"middle_name": "C.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-07",
"last_updated": "2018-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT 9591",
"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 Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.