Individual provider Active NPI

Lorraine Carol Niles, OTR/L

  • Mental Health Occupational Therapist
  • Oakland, CA
National Provider Identifier
1508139684
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Occupational TherapistTaxonomy code 225XM0800X
License
OT 11629 Issued in CA
Practice address
3310 Robinson Drive
Oakland, CA 94602-4136
Phone
(408) 821-9165
NPI assigned
Feb 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Occupational Therapist 225XM0800X OT 11629 CA Primary

Addresses

Primary practice location

3310 Robinson Drive
Oakland, CA 94602-4136

Mailing address

3310 Robinson Drive
Oakland, CA 94602-4136
Phone (408) 821-9165

Other identifiers 1

IdentifierTypeStateIssuer
1558392423OtherCAMEDICARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 11629CAMDMental Health Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1508139684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 ROBINSON DRIVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946024136",
            "telephone_number": "408-821-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 ROBINSON DRIVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946024136",
            "telephone_number": "408-821-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES",
        "first_name": "LORRAINE",
        "middle_name": "CAROL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "CA",
            "license": "OT 11629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1558392423",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.