Individual provider Active NPI

Jasmine Tagorda, OTR

  • Occupational Therapist
  • Costa Mesa, CA
National Provider Identifier
1366119349
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1640 Newport Blvd Ste 260
Costa Mesa, CA 92627-7736
Phone
(949) 335-7967
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 CA Primary

Addresses

Primary practice location

1640 Newport Blvd Ste 260
Costa Mesa, CA 92627-7736

Mailing address

24391 Avenida de la Carlota Apt 370
Laguna Hills, CA 92653-7655
Phone (626) 483-7855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211206001348 CA Practitioner - Occupational Therapist in Private Practice 1951791904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 Newport Blvd
Suite 260
Costa Mesa, CA 92627-7736
Phone (949) 335-7967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22830CAMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
California Rehab & Sports Therapy CurrentSince Sep 21, 2021 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther CurrentSince Sep 21, 2021 Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

14135 Francisquito Ave
Ste 100
Baldwin Park, CA 91706
Phone (626) 430-2300

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

1640 Newport Blvd
Ste 260
Costa Mesa, CA 92627
Phone (949) 335-7967

12555 Lakewood Blvd
Ste D
Downey, CA 90242
Phone (562) 777-1333

7071 Warner Ave
Ste A
Huntington Beach, CA 92647
Phone (714) 847-3800

4950 Barranca Pkwy
Ste 302
Irvine, CA 92604
Phone (949) 346-1486

36 Mauchly
Ste A
Irvine, CA 92618
Phone (949) 374-3315

24050 Aliso Creek Rd
Ste 1C
Laguna Niguel, CA 92677
Phone (949) 317-4454

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

26302 La Paz Rd
Ste 105
Mission Viejo, CA 92691
Phone (949) 206-1700

200 Newport Center Dr
Ste 213
Newport Beach, CA 92660
Phone (949) 644-0316

12539 Imperial Hwy
Ste 201
Norwalk, CA 90650
Phone (562) 379-9541

3111 N Tustin St
Ste 180
Orange, CA 92865
Phone (714) 282-7701

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1366119349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24391 AVENIDA DE LA CARLOTA APT 370",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537655",
            "telephone_number": "626-483-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 260",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277736",
            "telephone_number": "949-335-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGORDA",
        "first_name": "JASMINE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.