Individual provider Active NPI

Nicole Degracia

  • Occupational Therapy Assistant
  • Whittier, CA
National Provider Identifier
1508452640
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5338 Issued in CA
Practice address
12411 Slauson Ave
Whittier, CA 90606-2835
Phone
(562) 693-5449
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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 5338 CA Primary

Addresses

Primary practice location

12411 Slauson Ave
Whittier, CA 90606-2835

Mailing address

12511 Valencia St
Cerritos, CA 90703-7742

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

Practice roles

OrganizationSpecialtyStatusNew patients
DG Therapy PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1508452640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12511 VALENCIA ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12411 SLAUSON AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062835",
            "telephone_number": "562-693-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRACIA",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.