Active NPI
Jaldeza Taka
- Occupational Therapist
- Peabody, MA
National Provider Identifier
1477737435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9454
- Practice address
- 2 Buttonwood LN
Peabody, MA 01960-3116 - Phone
- (978) 821-1028
- NPI assigned
- Dec 26, 2007
- Last updated
- Dec 26, 2007
- 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 Therapist | 225X00000X | 9454 | MA | Primary |
Addresses
Primary practice location
2 Buttonwood LN
Peabody, MA 01960-3116
Mailing address
2 Buttonwood LN
Peabody, MA 01960-3116
Phone (978) 821-1028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S31418226 | Other | MA | DRIVER'S LICENSE |
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 |
|---|---|---|---|
| 9454 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1477737435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BUTTONWOOD LN",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603116",
"telephone_number": "978-821-1028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 BUTTONWOOD LN",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603116",
"telephone_number": "978-821-1028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKA",
"first_name": "JALDEZA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-26",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "9454",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "S31418226",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.