Individual provider Active NPI

Gwendoline R Cudiamat, OTR

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1639316904
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 9101 Issued in CA
Practice address
3000 Wilshire Blvd
211
Los Angeles, CA 90010-1136
Phone
(213) 738-0999
NPI assigned
Jan 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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 OT 9101 CA Primary

Addresses

Primary practice location

3000 Wilshire Blvd
211
Los Angeles, CA 90010-1136

Mailing address

3000 Wilshire Blvd
211
Los Angeles, CA 90010-1136
Phone (213) 738-0999

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
OT 9101CAMDOccupational Therapist
9101CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1639316904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WILSHIRE BLVD",
            "address_2": "211",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101136",
            "telephone_number": "213-738-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WILSHIRE BLVD",
            "address_2": "211",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101136",
            "telephone_number": "213-738-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDIAMAT",
        "first_name": "GWENDOLINE",
        "middle_name": "R",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 9101",
            "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 Jan 8, 2009; 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.