Adi Nisimov

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

23005 Issued in CA

Practice address

4923 Densmore Ave
Encino, CA 91436-1537

Phone

(818) 288-5314

NPI assigned

Aug 11, 2019

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1565481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1124674734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 DENSMORE AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361537",
            "telephone_number": "818-288-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 DENSMORE AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361537",
            "telephone_number": "818-288-5314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14515 Hamlin St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914111686",
            "country_code": "US",
            "telephone_number": "818-989-7475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISIMOV",
        "first_name": "ADI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-11",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "23005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Levon Nikoghosyan
• Jennifer Marie Niles, M.S., MFT
• Niloofar Nicole Javaheriana Chirocare
• Justin Ace Nilson
• Faye Nip
• Peter C Nissler, DDS
• Joy Kathleen Nitro
• Nitron Medical Diagnostics PC
• Gary J. Nitti, M.D.
• Joseph Thomas Nitti, MD

• Occupational Therapist in Encino, CA
• Providers in Encino, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.