Individual provider Active NPI

Corina Isabel Necesito, OTR/L

  • Pediatric Occupational Therapist
  • Claremont, CA
National Provider Identifier
1093204216
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
7791 Issued in CA
Practice address
630 S Indian Hill Blvd Ste 5
Claremont, CA 91711-5461
Phone
(213) 618-9149
NPI assigned
May 2, 2018
Last updated
Apr 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 7791 CA Primary

Addresses

Primary practice location

630 S Indian Hill Blvd Ste 5
Claremont, CA 91711-5461

Mailing address

1973 Austin CT
Claremont, CA 91711-2822

Other identifiers 1

IdentifierTypeStateIssuer
7791OtherCABOARD OF OT

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
7791CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Child Therapy. Inc. Current Accepting new patients

Locations

630 S Indian Hill Blvd
Ste 5
Claremont, CA 91711
Phone (909) 451-8521

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1093204216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1973 AUSTIN CT",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S INDIAN HILL BLVD STE 5",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917115461",
            "telephone_number": "213-618-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NECESITO",
        "first_name": "CORINA ISABEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "7791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF OT",
            "identifier": "7791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.