Individual provider Active NPI

Nadine Angulo

  • Occupational Therapy Assistant
  • Garden Grove, CA
National Provider Identifier
1578230439
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4141 Issued in CA
Practice address
12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027
Phone
(714) 750-9700
Fax
(714) 750-9797
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 4141 CA Primary

Addresses

Primary practice location

12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027

Mailing address

PO Box 1726
Westminster, CA 92684-1726
Phone (714) 750-9700

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
Kid Fundamentals Therapy Center, Inc. CurrentSince Jun 18, 2023 Accepting new patients

Locations

12900B Garden Grove Blvd
Ste 235
Garden Grove, CA 92843
Phone (714) 750-9700

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1578230439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1726",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926841726",
            "telephone_number": "714-750-9700",
            "fax_number": "714-750-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900B GARDEN GROVE BLVD STE 235",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432027",
            "telephone_number": "714-750-9700",
            "fax_number": "714-750-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGULO",
        "first_name": "NADINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "4141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.