Lydia Jane Okafor -Agilo

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

8385 Issued in CA

Practice address

10626 Balboa Blvd
Granada Hills, CA 91344-6329

Phone

(310) 902-5733

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1538866595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17067 JERSEY ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444926",
            "telephone_number": "310-902-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10626 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446329",
            "telephone_number": "310-902-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAFOR -AGILO",
        "first_name": "LYDIA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "8385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Physical Rehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.