Active NPI
John Resurreccion
- Occupational Therapist
- Gardena, CA
National Provider Identifier
1124597562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19693
- Practice address
- 15331 Jasmine LN Unit 106
Gardena, CA 90249-4692 - Phone
- (562) 857-4671
- NPI assigned
- Nov 14, 2018
- 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 Therapist | 225X00000X | 19693 | CA | Primary |
Addresses
Primary practice location
15331 Jasmine LN Unit 106
Gardena, CA 90249-4692
Mailing address
15331 Jasmine LN Unit 106
Gardena, CA 90249-4692
Phone (562) 857-4671
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 |
|---|---|---|---|
| 19693 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619913600000",
"number": "1124597562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15331 JASMINE LN UNIT 106",
"city": "GARDENA",
"state": "CA",
"postal_code": "902494692",
"telephone_number": "562-857-4671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15331 JASMINE LN UNIT 106",
"city": "GARDENA",
"state": "CA",
"postal_code": "902494692",
"telephone_number": "562-857-4671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESURRECCION",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-14",
"last_updated": "2021-05-02",
"certification_date": "2021-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "19693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.