Active NPI
Von Llave, OTR, CSST
- Occupational Therapist
- Wilmington, CA
National Provider Identifier
1184940769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9472
- Practice address
- 1643 W Pacific Coast Hwy
#39
Wilmington, CA 90744-1876 - Phone
- (310) 803-7938
- NPI assigned
- Apr 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 9472 | CA | Primary |
Addresses
Primary practice location
1643 W Pacific Coast Hwy
#39
Wilmington, CA 90744-1876
Mailing address
1643 West Pacific Coast Highway
#39
Wilmington, CA 90744
Phone (310) 803-7938
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 |
|---|---|---|---|
| 9472 | CA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270684800000",
"number": "1184940769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 WEST PACIFIC COAST HIGHWAY",
"address_2": "#39",
"city": "WILMINGTON",
"state": "CA",
"postal_code": "90744",
"telephone_number": "310-803-7938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1643 W PACIFIC COAST HWY",
"address_2": "#39",
"city": "WILMINGTON",
"state": "CA",
"postal_code": "907441876",
"telephone_number": "310-803-7938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLAVE",
"first_name": "VON",
"name_prefix": "Mr.",
"credential": "OTR, CSST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-08",
"last_updated": "2010-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "9472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.