Individual provider Active NPI

Amandarose Prado Webb

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1235747692
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
19992 Issued in CA
Practice address
3112 Bagley Ave Apt 7
Los Angeles, CA 90034-2939
Phone
(310) 465-9139
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 19992 CA Primary

Addresses

Primary practice location

3112 Bagley Ave Apt 7
Los Angeles, CA 90034-2939

Mailing address

3112 Bagley Ave Apt 7
Los Angeles, CA 90034-2939
Phone (310) 465-9139

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19992CAMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1235747692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 BAGLEY AVE APT 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342939",
            "telephone_number": "310-465-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 BAGLEY AVE APT 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342939",
            "telephone_number": "310-465-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "AMANDAROSE",
        "middle_name": "PRADO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "19992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.