Active NPI
Charlene Delos Reyes Traballo, OTR/L
- Occupational Therapist
- Montebello, CA
National Provider Identifier
1245628908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10915
- Practice address
- 1035 W Beverly Blvd
Montebello, CA 90640-4138 - Phone
- (323) 723-1315
- NPI assigned
- Jan 5, 2015
- 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 | 10915 | CA | Primary |
Addresses
Primary practice location
1035 W Beverly Blvd
Montebello, CA 90640-4138
Mailing address
619 W Graves Ave
Monterey Park, CA 91754-3826
Phone (323) 803-9980
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 |
|---|---|---|---|
| 10915 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1245628908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 W GRAVES AVE",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917543826",
"telephone_number": "323-803-9980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 W BEVERLY BLVD",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906404138",
"telephone_number": "323-723-1315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRABALLO",
"first_name": "CHARLENE",
"middle_name": "DELOS REYES",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-05",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "10915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montebello, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.