Individual provider Active NPI

Keenya Burries

  • Occupational Therapy Assistant
  • Rancho Cucamonga, CA
National Provider Identifier
1356971659
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
8282 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-7681
Phone
(909) 586-0509
NPI assigned
Jan 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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 CA Primary

Addresses

Primary practice location

8282 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-7681

Mailing address

8282 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-7681

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": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1356971659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8282 WHITE OAK AVE STE 107",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8282 WHITE OAK AVE STE 107",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307681",
            "telephone_number": "909-586-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIES",
        "first_name": "KEENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-25",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2020; 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.