Javier Nayib Villalobos Plascencia, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC61616958 Issued in WA

Practice address

17624 15TH Ave SE Ste 111a
Bothell, WA 98012-5107

Phone

(425) 371-5698

Fax

(425) 217-5923

NPI assigned

Dec 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1275359549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 WOODINVILLE DR TRLR 89",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113227",
            "telephone_number": "425-691-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17624 15TH AVE SE STE 111A",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980125107",
            "telephone_number": "425-371-5698",
            "fax_number": "425-217-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS PLASCENCIA",
        "first_name": "JAVIER",
        "middle_name": "NAYIB",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC61616958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Bothell, WA
• Providers in Bothell, WA by specialty
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.