Individual provider Active NPI

Jeffrey Minoru Yamada

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1376065862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13890 Issued in CA
Practice address
2051 Marengo St
Los Angeles, CA 90033-1352
Phone
(323) 409-7437
NPI assigned
Jul 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 OT13890 CA Primary

Addresses

Primary practice location

2051 Marengo St
Los Angeles, CA 90033-1352

Mailing address

2051 Marengo St
Los Angeles, CA 90033-1352
Phone (323) 409-7437

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
OT13890CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376065862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352",
            "telephone_number": "323-409-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352",
            "telephone_number": "323-409-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "JEFFREY",
        "middle_name": "MINORU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT13890",
            "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 Jul 21, 2022; 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.