Individual provider Active NPI

Ida Grandjean Due

  • Occupational Therapist
  • Long Beach, CA
National Provider Identifier
1366304289
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027
Phone
(562) 424-9000
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 Primary

Addresses

Primary practice location

3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027

Mailing address

3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ross Nathan MD, Inc. PastSince Dec 7, 2025 Accepting new patients
KMK Clinical Inc Occupational Therapist PastSince Dec 7, 2025 Accepting new patients

Organizations & group practices 2

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": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1366304289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 LONG BEACH BLVD STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 LONG BEACH BLVD STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076027",
            "telephone_number": "562-424-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUE",
        "first_name": "IDA",
        "middle_name": "GRANDJEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.