Active NPI
Jasen Pacis, OTR/L
- Occupational Therapist
- Tustin, CA
National Provider Identifier
1467158980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT24478
- Practice address
- 111 Fashion LN Unit 210
Tustin, CA 92780-3306 - Phone
- (949) 590-9350
- NPI assigned
- Feb 6, 2023
- Sex
- Male
- 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 | OT24478 | CA | Primary |
Addresses
Primary practice location
111 Fashion LN Unit 210
Tustin, CA 92780-3306
Mailing address
16922 New Pine Dr
Hacienda Heights, CA 91745-5741
Phone (714) 883-2061
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 |
|---|---|---|---|
| OT24478 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1467158980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16922 NEW PINE DR",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917455741",
"telephone_number": "714-883-2061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 FASHION LN UNIT 210",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803306",
"telephone_number": "949-590-9350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACIS",
"first_name": "JASEN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-06",
"last_updated": "2023-02-06",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT24478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.