Active NPI
Pamela Antoinette Stewart
- Specialist
- Pasadena, CA
National Provider Identifier
1215309208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 628
- Practice address
- 77 N Holliston Ave
Apt 4
Pasadena, CA 91106-1944 - Phone
- (626) 616-2962
- NPI assigned
- Oct 29, 2015
- Last updated
- Oct 29, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 628 | CA | Primary |
Addresses
Primary practice location
77 N Holliston Ave
Apt 4
Pasadena, CA 91106-1944
Mailing address
77 N Holliston Ave
Apt 4
Pasadena, CA 91106-1944
Phone (626) 616-2962
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 628 | Other | CA | CERTIFIED OCCUPATIONAL THERAPY ASSISTANT |
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 |
|---|---|---|---|
| 628 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446076800000",
"number": "1215309208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 N HOLLISTON AVE",
"address_2": "APT 4",
"city": "PASADENA",
"state": "CA",
"postal_code": "911061944",
"telephone_number": "626-616-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 N HOLLISTON AVE",
"address_2": "APT 4",
"city": "PASADENA",
"state": "CA",
"postal_code": "911061944",
"telephone_number": "626-616-2962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "PAMELA",
"middle_name": "ANTOINETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-29",
"last_updated": "2015-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED OCCUPATIONAL THERAPY ASSISTANT",
"identifier": "628",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.