Active NPI
Mariem William Metry
- Occupational Therapist
- Pomona, CA
National Provider Identifier
1386996734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12858
- Practice address
- 255 E Bonita Ave
Pomona, CA 91767-1923 - Phone
- (626) 675-7696
- NPI assigned
- Oct 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12858 | CA | Primary |
Addresses
Primary practice location
255 E Bonita Ave
Pomona, CA 91767-1923
Mailing address
1706 Lordsburg CT
La Verne, CA 91750-5682
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12858 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1386996734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 LORDSBURG CT",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 E BONITA AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917671923",
"telephone_number": "626-675-7696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METRY",
"first_name": "MARIEM",
"middle_name": "WILLIAM",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-10",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "12858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.