Elizabeth Kpachavi Restivo, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

14905 Issued in CA

Practice address

10716 La Tuna Canyon Rd
Sun Valley, CA 91352-2130

Phone

(818) 252-5863

NPI assigned

Jan 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1386982353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15053 BLACKHAWK ST",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452501",
            "telephone_number": "818-618-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10716 LA TUNA CANYON RD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522130",
            "telephone_number": "818-252-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "ELIZABETH",
        "middle_name": "KPACHAVI",
        "name_prefix": "Ms.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2024-05-07",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "14905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Sun Valley, CA
• Providers in Sun Valley, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.