Active NPI
Kenneth David Morrison Jr., COTA
- Occupational Therapy Assistant
- Anaheim, CA
National Provider Identifier
1114165974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1591
- Practice address
- 4853 E Wasatch Dr
Anaheim, CA 92807-3037 - Phone
- (714) 292-2716
- NPI assigned
- Jan 30, 2009
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | 1591 | CA | Primary |
Addresses
Primary practice location
4853 E Wasatch Dr
Anaheim, CA 92807-3037
Mailing address
4853 E Wasatch Dr
Anaheim, CA 92807-3037
Phone (714) 292-2716
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1591 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1114165974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4853 E WASATCH DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073037",
"telephone_number": "714-292-2716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4853 E WASATCH DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073037",
"telephone_number": "714-292-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISON",
"first_name": "KENNETH",
"middle_name": "DAVID",
"name_suffix": "Jr.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-30",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "1591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.