Dayannara Campos Medina, OTD
Individual provider Active NPI Pediatric Occupational Therapist · La Verne, CA
NPI 1124987706 · NPPES record last updated Jan 19, 2026
Key facts
- NPI
- 1124987706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- 28458 (CA)
- Practice address
- 2120 Foothill Blvd Ste 115
La Verne, CA 91750-2949 - Phone
- (888) 647-3622
- NPI assigned
- Jan 19, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28458 | CA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Family Tree, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 28458 | CA | Yes |
Addresses
Primary practice location
2120 Foothill Blvd Ste 115
La Verne, CA 91750-2949
Mailing address
2120 Foothill Blvd Ste 115
La Verne, CA 91750-2949
Other providers in La Verne, CA
- C&L Medical Group Inc.
- Jennifer Hulsha Cabanas
- California Stat Laboratories
- Calm Path Psychological Services, Inc.
- Gricel Calzada
- Angie Canales
- Beatriz Canales
- Kyoko Canizales
- Melissa Capacete
- Alicia Cardenas
All providers in La Verne, CA · Pediatric Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.