Active NPI
Marichu Lazo, COTA
- Occupational Therapy Assistant
- Bloomfield, NM
National Provider Identifier
1427364090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2456
- Practice address
- 803 Hacienda Lane
Bloomfield, NM 87413 - Phone
- (505) 360-0799
- NPI assigned
- Aug 20, 2010
- Last updated
- Aug 20, 2010
- 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 Therapy Assistant | 224Z00000X | 2456 | NM | Primary |
Addresses
Primary practice location
803 Hacienda Lane
Bloomfield, NM 87413
Mailing address
318 N 7TH St
Bloomfield, NM 87413-5581
Phone (505) 360-0799
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 |
|---|---|---|---|
| 2456 | NM | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1427364090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 N 7TH ST",
"city": "BLOOMFIELD",
"state": "NM",
"postal_code": "874135581",
"telephone_number": "505-360-0799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 HACIENDA LANE",
"city": "BLOOMFIELD",
"state": "NM",
"postal_code": "87413",
"telephone_number": "505-360-0799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZO",
"first_name": "MARICHU",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-20",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "2456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomfield, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.