Individual provider Active NPI

Venessa D Vigil, O.T.

  • Occupational Therapist
  • Long Beach, CA
National Provider Identifier
1427009935
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 6928 Issued in CA
Practice address
2888 Long Beach Blvd
#405
Long Beach, CA 90806-1530
Phone
(562) 595-4489
Fax
(562) 595-4063
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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 OT 6928 CA Primary

Addresses

Primary practice location

2888 Long Beach Blvd
#405
Long Beach, CA 90806-1530

Mailing address

200 Newport Center Dr
#213
Newport Beach, CA 92660-7501
Phone (949) 644-1322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000403 CA Practitioner - Occupational Therapist in Private Practice 5597658591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 6928CAMDOccupational Therapist
6928CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther CurrentSince Nov 14, 2005 Accepting new patients
California Rehab & Sports Therapy CurrentSince Nov 14, 2005 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
Shattuck Rehabilitation Services Occupational Therapist PastSince Feb 2, 2004 Accepting new patients
Hands on Hands Rehabilitation Center, Inc PastSince Jun 1, 2017 Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

200 Newport Center Dr
Ste 213
Newport Beach, CA 92660
Phone (949) 644-0316

Organizations & group practices 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1427009935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "#213",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "949-644-1322",
            "fax_number": "949-644-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 LONG BEACH BLVD",
            "address_2": "#405",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061530",
            "telephone_number": "562-595-4489",
            "fax_number": "562-595-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "VENESSA",
        "middle_name": "D",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 6928",
            "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 Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.