Individual provider Active NPI

Shelby Esther Surfas, OTD, OTR/L

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1295050045
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8109 Issued in CA
Practice address
4650 Sunset Blvd
Mailstop #53
Los Angeles, CA 90027-0980
Phone
(323) 361-2300
Fax
(323) 361-8305
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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 8109 CA Primary

Addresses

Primary practice location

4650 Sunset Blvd
Mailstop #53
Los Angeles, CA 90027-0980

Mailing address

4650 Sunset Blvd
Mailstop #53
Los Angeles, CA 90027-0980
Phone (323) 361-2300

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

LicenseStateTypeSpecialty
8109CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1295050045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD",
            "address_2": "MAILSTOP #53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900270980",
            "telephone_number": "323-361-2300",
            "fax_number": "323-361-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD",
            "address_2": "MAILSTOP #53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900270980",
            "telephone_number": "323-361-2300",
            "fax_number": "323-361-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURFAS",
        "first_name": "SHELBY",
        "middle_name": "ESTHER",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "8109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.