Active NPI
Eriberto Selma Beduya Jr., OTA/L
- Occupational Therapy Assistant
- Granada Hills, CA
National Provider Identifier
1194480038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3581
- Practice address
- 17326 Kingsbury St
Granada Hills, CA 91344-6110 - Phone
- (818) 217-9677
- NPI assigned
- Nov 5, 2021
- 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 Therapy Assistant | 224Z00000X | 3581 | CA | Primary |
Addresses
Primary practice location
17326 Kingsbury St
Granada Hills, CA 91344-6110
Mailing address
17326 Kingsbury St
Granada Hills, CA 91344-6110
Phone (818) 217-9677
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 |
|---|---|---|---|
| 3581 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1194480038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17326 KINGSBURY ST",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913446110",
"telephone_number": "818-217-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17326 KINGSBURY ST",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913446110",
"telephone_number": "818-217-9677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDUYA",
"first_name": "ERIBERTO",
"middle_name": "SELMA",
"name_suffix": "Jr.",
"credential": "OTA/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-05",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "3581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granada Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.