Individual provider Active NPI

Shayna Lily Quach, OTR/L

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1598485500
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
24008 Issued in CA
Practice address
955 Carrillo Dr Ste 103
Los Angeles, CA 90048-5400
Phone
(310) 854-0529
NPI assigned
Aug 30, 2022
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 24008 CA Primary

Addresses

Primary practice location

955 Carrillo Dr Ste 103
Los Angeles, CA 90048-5400

Mailing address

955 Carrillo Dr Ste 103
Los Angeles, CA 90048-5400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221120000033 CA Practitioner - Occupational Therapist in Private Practice 2567830797 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
California Rehab & Sports Therapy CurrentSince Aug 9, 2022 Accepting new patients
Access Rehab Physical Therapy PC Occupational Therapist CurrentSince Jan 1, 2025 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther CurrentSince Aug 9, 2022 Accepting new patients
Ufit Physical Therapy Enterprise Occupational Therapist Current Accepting new patients

Locations

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

955 Carrillo Dr
Ste 103
Los Angeles, CA 90048
Phone (310) 659-1077

630 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 592-2778

19000 Hawthorne Blvd
Ste 300
Torrance, CA 90503
Phone (310) 793-1800

Organizations & group practices 5

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1598485500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485400",
            "telephone_number": "310-854-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACH",
        "first_name": "SHAYNA",
        "middle_name": "LILY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "24008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.