Individual provider Active NPI

Marisa Yumi Sanwo, OTR

  • Gerontology Occupational Therapist
  • Anaheim, CA
National Provider Identifier
1568700532
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
16076 Issued in CA
Practice address
1731 W Medical Center Dr
Anaheim, CA 92801-1837
Phone
(714) 778-5100
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gerontology Occupational Therapist 225XG0600X 16076 CA Primary

Addresses

Primary practice location

1731 W Medical Center Dr
Anaheim, CA 92801-1837

Mailing address

5139 McCallum Avenue
Back Unit
South Gate, CA 90280-2426
Phone (661) 755-3872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830000379 CA Practitioner - Occupational Therapist in Private Practice 6204210982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Clarita Valley Therapy ServicesGroup PAC ID 0244294163, 8 clinicians

Practice addresses (Care Compare)

25129 The Old Rd
Suite 100
Stevenson Ranch, CA 91381-2281
Phone (661) 284-1984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16076CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince May 18, 2022 Accepting new patients
Orthopaedic and Neurological Rehab Inc CurrentSince May 18, 2022 Accepting new patients
Santa Clarita Valley Therapy Services CurrentSince May 16, 2024 Accepting new patients
MD Solutions Medical Corp PastSince May 16, 2024 Accepting new patients

Locations

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

25129 The Old Rd
Ste 100
Stevenson Rnh, CA 91381
Phone (661) 284-1984

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 571-2603

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 4

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": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1568700532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 MCCALLUM AVENUE",
            "address_2": "BACK UNIT",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802426",
            "telephone_number": "661-755-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 W MEDICAL CENTER DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011837",
            "telephone_number": "714-778-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANWO",
        "first_name": "MARISA",
        "middle_name": "YUMI",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "CA",
            "license": "16076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.