Madison Vander Broek, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

29134 Issued in CA

Practice address

1301 W Arrow Hwy Ste 130
San Dimas, CA 91773-2330

Phone

(909) 228-9806

NPI assigned

May 29, 2026

Last updated

Jun 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1477485001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W ARROW HWY STE 130",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732330",
            "telephone_number": "909-228-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W ARROW HWY STE 130",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732330",
            "telephone_number": "909-228-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER BROEK",
        "first_name": "MADISON",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "29134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.