Individual provider Active NPI

Gloria Cynthia Yambot, OTR/L

  • Occupational Therapist
  • Stockton, CA
National Provider Identifier
1619456258
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
10528 Issued in CA
Practice address
1517 Knickerbocker Dr
Stockton, CA 95210-3119
Phone
(209) 957-6758
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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 10528 CA Primary

Addresses

Primary practice location

1517 Knickerbocker Dr
Stockton, CA 95210-3119

Mailing address

2546 Etcheverry Dr
Stockton, CA 95212-3013
Phone (209) 331-0879

Other practice location 1

1032 N Lincoln St
Stockton, CA 95203-2409
Phone (209) 466-5341

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

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1619456258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 ETCHEVERRY DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952123013",
            "telephone_number": "209-331-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 KNICKERBOCKER DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103119",
            "telephone_number": "209-957-6758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1032 N Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952032409",
            "country_code": "US",
            "telephone_number": "209-466-5341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMBOT",
        "first_name": "GLORIA",
        "middle_name": "CYNTHIA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "10528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.