Active NPI
Bertha Brown Holliday, O.T.R.L.
- Occupational Therapist
- Panorama City, CA
National Provider Identifier
1235252479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6947
- Practice address
- 13652 Cantara St.
Balboa Plaza
Panorama City, CA 91492 - Phone
- (818) 832-7200
- NPI assigned
- Apr 10, 2007
- 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 | 6947 | CA | Primary |
Addresses
Primary practice location
13652 Cantara St.
Balboa Plaza
Panorama City, CA 91492
Mailing address
PO Box 5654
Pasadena, CA 91117-0654
Phone (626) 392-5634
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 |
|---|---|---|---|
| 6947 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235252479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5654",
"city": "PASADENA",
"state": "CA",
"postal_code": "911170654",
"telephone_number": "626-392-5634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13652 CANTARA ST.",
"address_2": "BALBOA PLAZA",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "91492",
"telephone_number": "818-832-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIDAY",
"first_name": "BERTHA",
"middle_name": "BROWN",
"credential": "O.T.R.L.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "6947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.