Mone Blackburn, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

24513 Issued in CA

Practice address

1225 W 190TH St Ste 103
Gardena, CA 90248-4315

Phone

(310) 819-8680

NPI assigned

Jan 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1285349381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 ORCHARD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373021",
            "telephone_number": "323-369-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 103",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484315",
            "telephone_number": "310-819-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MONE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "24513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moneb@playtasticpediatric.com",
            "affiliation": "N",
            "address_1": "1225 W 190th St Ste 103",
            "city": "Gardena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902484315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roxette Bisarra
• Lorraine Carla B Biteranta
• Rosie Bittman
• Kenli T Black, COMMUNITY PEER
• Tiffany Alex Black
• Rochelle Blackett
• Mercedes Blackwell
• Erika Blancq Fernandez
• Marcia Smith Blank, AU.D.
• Tiffany Diane Blanton, LCSW

• Pediatric Occupational Therapist in Gardena, CA
• Providers in Gardena, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.