Individual provider Active NPI

Wendy Yang, OTR/L

  • Occupational Therapist
  • Fullerton, CA
National Provider Identifier
1245598580
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 4415 Issued in CA
Practice address
2222 N Harbor Blvd
Fullerton, CA 92835-2605
Phone
(714) 992-5701
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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 OT 4415 CA Primary

Addresses

Primary practice location

2222 N Harbor Blvd
Fullerton, CA 92835-2605

Mailing address

2759 Somerset PL
Rowland Heights, CA 91748-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926001141 CA Practitioner - Occupational Therapist in Private Practice 4789958075 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 4415CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scosi Orthopedics Inc CurrentSince Sep 7, 2017 Accepting new patients
Aeon Physical Therapy Corp CurrentSince Mar 25, 2020 Accepting new patients

Locations

18575 Gale Ave
Ste 278
City of Industry, CA 91748
Phone (626) 559-5181

175 W La Verne Ave
Ste A
Pomona, CA 91767
Phone (909) 593-5515

Organizations & group practices 2

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1245598580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 SOMERSET PL",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917484878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352605",
            "telephone_number": "714-992-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "WENDY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 4415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.