Individual provider Active NPI

Henry Go Penaranda, OTRL

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1134429004
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
10295 Issued in CA
Practice address
3540 Wilshire Blvd
314
Los Angeles, CA 90010-2307
Phone
(213) 389-1141
Fax
(213) 389-1171
NPI assigned
Oct 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10295 CA Primary

Addresses

Primary practice location

3540 Wilshire Blvd
314
Los Angeles, CA 90010-2307

Mailing address

3540 Wilshire Blvd
314
Los Angeles, CA 90010-2307
Phone (213) 389-1141

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10295CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JH Physical Therapy Inc Past Accepting new patients
West Wellness Physical Therapy & Rehab Inc Occupational Therapist Past Accepting new patients
Vins Physical Therapy Inc Occupational Therapist PastSince Jan 2, 2013 Accepting new patients
MGR Physical Therapy Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1134429004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 WILSHIRE BLVD",
            "address_2": "314",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102307",
            "telephone_number": "213-389-1141",
            "fax_number": "213-389-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 WILSHIRE BLVD",
            "address_2": "314",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102307",
            "telephone_number": "213-389-1141",
            "fax_number": "213-389-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENARANDA",
        "first_name": "HENRY",
        "middle_name": "GO",
        "name_prefix": "Mr.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "10295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.