Active NPI
Kayla Nicholson, OTD, OTR/L
- Occupational Therapist
- Norco, CA
National Provider Identifier
1497220891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 26809
- Practice address
- 2641 Hamner Ave Ste 110
Norco, CA 92860-3637 - Phone
- (626) 536-4834
- NPI assigned
- Oct 11, 2018
- 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 | 26809 | CA | Primary |
Addresses
Primary practice location
2641 Hamner Ave Ste 110
Norco, CA 92860-3637
Mailing address
731 Blankenship Cir
Placentia, CA 92870-7512
Phone (949) 327-1713
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 |
|---|---|---|---|
| 26809 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1497220891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 BLANKENSHIP CIR",
"city": "PLACENTIA",
"state": "CA",
"postal_code": "928707512",
"telephone_number": "949-327-1713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2641 HAMNER AVE STE 110",
"city": "NORCO",
"state": "CA",
"postal_code": "928603637",
"telephone_number": "626-536-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "KAYLA",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-11",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "26809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.