Individual provider Active NPI

Kristina M. Brickey, COTA/L

  • Occupational Therapy Assistant
  • Laguna Hills, CA
National Provider Identifier
1083167696
Registry record updated Jul 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2452 Issued in CA
Practice address
24422 Avenida de la Carlota Ste 100
Laguna Hills, CA 92653-3648
Phone
(949) 916-1654
NPI assigned
Jul 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2016

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 2452 CA Primary

Addresses

Primary practice location

24422 Avenida de la Carlota Ste 100
Laguna Hills, CA 92653-3648

Mailing address

324 N Parker St
Orange, CA 92868-2231
Phone (714) 470-5456

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
2452CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1469923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469923200000",
    "number": "1083167696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N PARKER ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682231",
            "telephone_number": "714-470-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24422 AVENIDA DE LA CARLOTA STE 100",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533648",
            "telephone_number": "949-916-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKEY",
        "first_name": "KRISTINA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-31",
        "last_updated": "2016-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "2452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2016; 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.