Active NPI
Kimberly Dawn Manzano Doctolero
- Pediatric Occupational Therapist
- Whittier, CA
National Provider Identifier
1235682824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Practice address
- 7313 Whittier Ave
Whittier, CA 90602-1132 - Phone
- (424) 442-9129
- Fax
- (310) 943-3821
- NPI assigned
- Jul 29, 2016
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | |||
| Pediatric Occupational Therapist | 225XP0200X | Primary |
Addresses
Primary practice location
7313 Whittier Ave
Whittier, CA 90602-1132
Mailing address
12433 Riverside Dr Apt 2
Valley Village, CA 91607-3564
Phone (702) 340-6356
Other practice location 1
8866 Dramatic Gold Ave
Las Vegas, NV 89178-6561
Phone (702) 340-6356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83-1142000 | Medicaid | CA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nurture Collective | Pediatrics | Current | Accepting new patients |
Locations
7313 Whittier Ave
Whittier, CA 90602
Phone (424) 442-9129
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1235682824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12433 RIVERSIDE DR APT 2",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916073564",
"telephone_number": "702-340-6356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7313 WHITTIER AVE",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906021132",
"telephone_number": "424-442-9129",
"fax_number": "310-943-3821"
}
],
"practiceLocations": [
{
"address_1": "8866 Dramatic Gold Ave",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891786561",
"country_code": "US",
"telephone_number": "702-340-6356",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOCTOLERO",
"first_name": "KIMBERLY DAWN",
"middle_name": "MANZANO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-29",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "83-1142000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whittier, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.