Active NPI
Raquel Agmon, OTR/L
- Occupational Therapist
- Lake Balboa, CA
National Provider Identifier
1396364790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 20968
- Practice address
- 6821 Texhoma Ave
Lake Balboa, CA 91406-4345 - Phone
- (818) 387-5884
- NPI assigned
- Apr 15, 2020
- Last updated
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 20968 | CA | Primary |
Addresses
Primary practice location
6821 Texhoma Ave
Lake Balboa, CA 91406-4345
Mailing address
6821 Texhoma Ave
Lake Balboa, CA 91406-4345
Phone (818) 387-5884
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feld Care Therapy Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586908800000",
"number": "1396364790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6821 TEXHOMA AVE",
"city": "LAKE BALBOA",
"state": "CA",
"postal_code": "914064345",
"telephone_number": "818-387-5884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6821 TEXHOMA AVE",
"city": "LAKE BALBOA",
"state": "CA",
"postal_code": "914064345",
"telephone_number": "818-387-5884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGMON",
"first_name": "RAQUEL",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-15",
"last_updated": "2020-04-15",
"certification_date": "2020-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "20968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Balboa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.