Individual provider Active NPI

Syed B Arif, COTA THERAPIST

  • Physical Rehabilitation Occupational Therapist
  • Stockton, CA
National Provider Identifier
1477176287
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OTA3617 Issued in CA
Practice address
442 E Hampton St
Stockton, CA 95204-5519
Phone
(209) 466-0456
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OTA3617 CA Primary

Addresses

Primary practice location

442 E Hampton St
Stockton, CA 95204-5519

Mailing address

504 Northbank CT Apt 127
Stockton, CA 95207-7649
Phone (786) 202-5033

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

LicenseStateTypeSpecialty
OTA3617CAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1477176287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 NORTHBANK CT APT 127",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077649",
            "telephone_number": "786-202-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 E HAMPTON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045519",
            "telephone_number": "209-466-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIF",
        "first_name": "SYED",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "COTA THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "OTA3617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.

Verify at the official NPI Registry.