Individual provider Active NPI

Rebecca Myres

  • Occupational Therapy Assistant
  • Fresno, CA
National Provider Identifier
1477911501
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA 1377 Issued in CA
Practice address
2505 W Shaw Ave BLDG a
Fresno, CA 93711-3334
Phone
(559) 228-9100
Fax
(559) 228-9200
NPI assigned
Feb 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA 1377 CA Primary

Addresses

Primary practice location

2505 W Shaw Ave BLDG a
Fresno, CA 93711-3334

Mailing address

2505 W Shaw Ave BLDG a
Fresno, CA 93711-3334
Phone (559) 228-9100

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
OTA 1377CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1477911501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 W SHAW AVE BLDG A",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113334",
            "telephone_number": "559-228-9100",
            "fax_number": "559-228-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 W SHAW AVE BLDG A",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113334",
            "telephone_number": "559-228-9100",
            "fax_number": "559-228-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRES",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA 1377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.