Active NPI
Tara A. Perry, OTD, OTR/L
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1174920185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14060
- Practice address
- 902 S Burnside Ave
Los Angeles, CA 90036-4743 - Phone
- (310) 890-4836
- NPI assigned
- Nov 20, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 14060 | CA | Primary |
Addresses
Primary practice location
902 S Burnside Ave
Los Angeles, CA 90036-4743
Mailing address
902 S. Burnside Ave
Los Angeles, CA 90036
Phone (310) 890-4836
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 |
|---|---|---|---|
| 14060 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1174920185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 S. BURNSIDE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90036",
"telephone_number": "310-890-4836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 S BURNSIDE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900364743",
"telephone_number": "310-890-4836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "TARA",
"middle_name": "A.",
"name_prefix": "Prof.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "14060",
"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 Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.