Mary Ellen Florendo-Tan, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT 1109 Issued in CA

Practice address

140 W San Jose Ave
Claremont, CA 91711-5204

Phone

(909) 621-2780

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pediatric Care Services, Inc

  dba PCS

  • Speech-Language Pathologist
  • Claremont, CA
  • NPI 1326371329
  NPD (past)

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1083942148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 E MAPLEGROVE ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921214",
            "telephone_number": "909-615-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W SAN JOSE AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917115204",
            "telephone_number": "909-621-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENDO-TAN",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "CA",
            "license": "OT1109",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 1109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun Eric Fernandez
• Alyssa Lorelle Fetters, MA, OTR/L
• Finding Light Family Counseling Services Inc (Finding Light Family Counseling)
• Aubrey Howard Fine, ED.D.
• Melissa Flor de Liz, LCSW
• Kristen Renee Flores, LCSW
• Foothill AIDS Project
• Foothill AIDS Project
• Foothill AIDS Project
• Foothill AIDS Project

• Pediatric Occupational Therapist in Claremont, CA
• Providers in Claremont, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.