Individual provider Active NPI

Monica M Petz

  • Occupational Therapy Assistant
  • Mission Viejo, CA
National Provider Identifier
1356626386
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2039 Issued in CA
Practice address
24492 Castelo Cir
Mission Viejo, CA 92691-5005
Phone
(949) 951-1528
NPI assigned
Oct 21, 2011
Last updated
Oct 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2039 CA Primary

Addresses

Primary practice location

24492 Castelo Cir
Mission Viejo, CA 92691-5005

Mailing address

24492 Castelo Cir
Mission Viejo, CA 92691-5005
Phone (949) 951-1528

Other identifiers 1

IdentifierTypeStateIssuer
2039MedicaidCA

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

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1356626386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24492 CASTELO CIR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915005",
            "telephone_number": "949-951-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24492 CASTELO CIR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915005",
            "telephone_number": "949-951-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETZ",
        "first_name": "MONICA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "2039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.