Active NPI
Jeremy Olivar
- Occupational Therapy Assistant
- Chatsworth, CA
National Provider Identifier
1235826249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3630
- Practice address
- 21820 Craggy View St
Chatsworth, CA 91311-2909 - Phone
- (818) 882-8233
- NPI assigned
- Apr 19, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3630 | CA | Primary |
Addresses
Primary practice location
21820 Craggy View St
Chatsworth, CA 91311-2909
Mailing address
15945 San Fernando Mission Blvd
Granada Hills, CA 91344-3934
Phone (818) 854-5846
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 |
|---|---|---|---|
| 3630 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1235826249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15945 SAN FERNANDO MISSION BLVD",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913443934",
"telephone_number": "818-854-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21820 CRAGGY VIEW ST",
"city": "CHATSWORTH",
"state": "CA",
"postal_code": "913112909",
"telephone_number": "818-882-8233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAR",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-19",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "3630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatsworth, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.