Individual provider Active NPI

Rosabelle Loan Nguyen, O.T.R./L

  • Occupational Therapist
  • Orange, CA
National Provider Identifier
1164557773
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT9205 Issued in CA
Practice address
1140 W. la Veta Avenue
Suite 860
Orange, CA 92868-4218
Phone
(714) 835-6500
Fax
(714) 541-6105
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT9205 CA Primary
Hand Occupational Therapist 225XH1200X OT9205 CA
Pediatric Occupational Therapist 225XP0200X OT9205 CA

Addresses

Primary practice location

1140 W. la Veta Avenue
Suite 860
Orange, CA 92868-4218

Mailing address

1140 W. la Veta Avenue
Suite 860
Orange, CA 92868-4218
Phone (714) 835-6500

Other identifiers 1

IdentifierTypeStateIssuer
OT0092050OtherCABLUE SHIELD PIN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Santa Margarita Physical Therapy Sports Medicine Inc CurrentSince Aug 8, 2013 Accepting new patients
Scor Physical Therapy Inc CurrentSince Aug 8, 2013 Accepting new patients
Sterling B Mutz MD Inc Julio Taleisnik MD Inc Et Al Hand PastSince Apr 8, 2014 Accepting new patients
Southland Physical Therapy, Inc. Occupational Therapist PastSince Jun 9, 2008 Accepting new patients
State College Physical Therapy Past Accepting new patients
State College Physical Therapy Inc Past Accepting new patients

Locations

29803 Santa Margarita Pkwy
Rcho Sta Marg, CA 92688
Phone (949) 459-9010

653 Camino de los Mares
Ste 110
San Clemente, CA 92673
Phone (949) 496-0122

Organizations & group practices 6

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1164557773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W. LA VETA AVENUE",
            "address_2": "SUITE 860",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684218",
            "telephone_number": "714-835-6500",
            "fax_number": "714-541-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W. LA VETA AVENUE",
            "address_2": "SUITE 860",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684218",
            "telephone_number": "714-835-6500",
            "fax_number": "714-541-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ROSABELLE",
        "middle_name": "LOAN",
        "credential": "O.T.R./L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT9205",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT9205",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT9205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "OT0092050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.