Active NPI
Jamie Hisa Mizuhara, MA OTR-L
- Occupational Therapist
- Orange, CA
National Provider Identifier
1245393750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5875
- Practice address
- 1301 W Providence Ave
Orange, CA 92868-3808 - Phone
- (714) 639-4990
- Fax
- (714) 744-3841
- NPI assigned
- Dec 18, 2006
- Last updated
- Jul 8, 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 | 5875 | CA | Primary |
Addresses
Primary practice location
1301 W Providence Ave
Orange, CA 92868-3808
Mailing address
1862 E Palm Dr
Covina, CA 91724-3127
Phone (626) 233-2131
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5875 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245393750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1862 E PALM DR",
"city": "COVINA",
"state": "CA",
"postal_code": "917243127",
"telephone_number": "626-233-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W PROVIDENCE AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683808",
"telephone_number": "714-639-4990",
"fax_number": "714-744-3841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZUHARA",
"first_name": "JAMIE",
"middle_name": "HISA",
"name_prefix": "Miss",
"credential": "MA OTR-L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "5875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, 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.