Charlene Yvette Johnson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA3306 Issued in CA

Practice address

743 Hill Ave
Apt#1
Shelby, MT 59474-2717

Phone

(949) 292-2176

NPI assigned

Oct 20, 2016

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1649721044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 HILL AVE",
            "address_2": "APT#1",
            "city": "SHELBY",
            "state": "MT",
            "postal_code": "594742717",
            "telephone_number": "949-292-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 HILL AVE",
            "address_2": "APT#1",
            "city": "SHELBY",
            "state": "MT",
            "postal_code": "594742717",
            "telephone_number": "949-292-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLENE",
        "middle_name": "YVETTE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Hout
• Courtney Hovland, RN
• Heidi Lynn Hunsucker, NP
• Shelly Hunt, LCPC
• Gregory Trandon Lee Jefferson
• Alexander Kastner
• Robin Lynn Laine
• Larry J. Bonderud, OD (Northern Montana Eyecare)
• Rachael Lehr, APRN
• Logan Health - Shelby (Marias Medical Center)

• Occupational Therapy Assistant in Shelby, MT
• Providers in Shelby, MT by specialty
• Occupational Therapy Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.