NPIMap

Organization Active NPI

Shattuck Rehabilitation Services

Doing business as Healing Hands Therapy & Wellness Center

  • Hand Occupational Therapist
  • Los Alamitos, CA
National Provider Identifier
1245361591
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
AA358119 Issued in CA
Legal business name
SHATTUCK REHABILITATION SERVICES
Doing business as
Healing Hands Therapy & Wellness Center
Practice address
4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681
Phone
(562) 430-8700
Fax
(562) 430-8760
NPI assigned
Mar 8, 2007
Last updated
Feb 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Jeanette Louise Shattuck, OTR LNPI 1003948928
Title
President
Phone
(562) 430-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X CA
Occupational Therapist 225X00000X AA358119 CA
Ergonomics Occupational Therapist 225XE1200X AA358119 CA
Hand Occupational Therapist 225XH1200X AA358119 CA Primary

Addresses

Primary practice location

4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681

Mailing address

4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681
Phone (562) 430-8700

Other identifiers 3

IdentifierTypeStateIssuer
08127ADOCOtherCAADOC ID
205696000OtherCADEPT OF LABOR ACS
ZZZ07888ZOtherCABLUE SHIELD GROUP

Other names 1

  • Healing Hands Therapy & Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

4772 Katella Ave
Ste 100
Los Alamitos, CA 90720
Phone (562) 430-8700

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1245361591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 KATELLA AVE STE 100",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202681",
            "telephone_number": "562-430-8700",
            "fax_number": "562-430-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 KATELLA AVE STE 100",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202681",
            "telephone_number": "562-430-8700",
            "fax_number": "562-430-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHATTUCK REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "SHATTUCK",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-430-8700",
        "authorized_official_credential": "OTR L"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "AA358119",
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "CA",
            "license": "AA358119",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "AA358119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADOC ID",
            "identifier": "08127ADOC",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR ACS",
            "identifier": "205696000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "ZZZ07888Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healing Hands Therapy & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.

Verify at the official NPI Registry.