Active NPI
Ryan Theobald, COTA
- Occupational Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1437061058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 6982
- Practice address
- 3977 Beverly Blvd Apt 118
Los Angeles, CA 90004-3999 - Phone
- (440) 591-3954
- NPI assigned
- Sep 18, 2026
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | 6982 | CA | Primary |
Addresses
Primary practice location
3977 Beverly Blvd Apt 118
Los Angeles, CA 90004-3999
Mailing address
3977 Beverly Blvd Apt 118
Los Angeles, CA 90004-3999
Phone (440) 591-3954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789689600000",
"number": "1437061058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3977 BEVERLY BLVD APT 118",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043999",
"telephone_number": "440-591-3954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3977 BEVERLY BLVD APT 118",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043999",
"telephone_number": "440-591-3954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEOBALD",
"first_name": "RYAN",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-18",
"last_updated": "2026-09-18",
"certification_date": "2026-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "6982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.