Darla Bradley
Individual provider Active NPI Occupational Therapy Assistant · La Verne, CA
NPI 1689437600 · NPPES record last updated Feb 1, 2024
Key facts
- NPI
- 1689437600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 3026 (CA)
- Practice address
- 2663 5TH St
La Verne, CA 91750-5026 - Phone
- (909) 764-4010
- NPI assigned
- Feb 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3026 | CA | Yes |
Addresses
Primary practice location
2663 5TH St
La Verne, CA 91750-5026
Mailing address
2663 5TH St
La Verne, CA 91750-5026
NPI Registry JSON
{
"created_epoch": "1706745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1689437600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2663 5TH ST",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2663 5TH ST",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505026",
"telephone_number": "909-764-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "DARLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-01",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "3026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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All providers in La Verne, CA · Occupational Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.