Active NPI
Cornell Allen Jr.
- Occupational Therapist
- Camarillo, CA
National Provider Identifier
1497021075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 09187
- Practice address
- 89 Palm Dr
Camarillo, CA 93010-7963 - Phone
- (805) 236-7807
- NPI assigned
- Mar 28, 2012
- 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 | 09187 | CA | Primary |
Addresses
Primary practice location
89 Palm Dr
Camarillo, CA 93010-7963
Mailing address
PO Box 483
Port Hueneme, CA 93044-0483
Phone (805) 236-7807
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 |
|---|---|---|---|
| 09187 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332892800000",
"number": "1497021075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 483",
"city": "PORT HUENEME",
"state": "CA",
"postal_code": "930440483",
"telephone_number": "805-236-7807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 PALM DR",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930107963",
"telephone_number": "805-236-7807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "CORNELL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-28",
"last_updated": "2012-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "09187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.