Active NPI
Clarissa Chavez, CPO
- Orthotist
- Long Beach, CA
National Provider Identifier
1194506444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- CPO05233
- Practice address
- 2933 Long Beach Blvd
Long Beach, CA 90806-1517 - Phone
- (562) 988-2414
- NPI assigned
- Oct 12, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CPO05233 | CA | Primary |
| Prosthetist | 224P00000X | CPO05233 | CA |
Addresses
Primary practice location
2933 Long Beach Blvd
Long Beach, CA 90806-1517
Mailing address
2933 Long Beach Blvd
Long Beach, CA 90806-1517
Phone (562) 988-2414
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 |
|---|---|---|---|
| CPO05233 | CA | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1194506444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2933 LONG BEACH BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061517",
"telephone_number": "562-988-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2933 LONG BEACH BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061517",
"telephone_number": "562-988-2414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "CLARISSA",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-12",
"last_updated": "2023-11-13",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "CA",
"license": "CPO05233",
"primary": true
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "CA",
"license": "CPO05233",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.