Katrina Jean Mondejar Yan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT15532 Issued in CA

Practice address

740 S. Pacentia Ave.
Ste 100
Placentia, CA 92870-6832

Phone

(714) 646-8318

Fax

(714) 646-8320

NPI assigned

Sep 30, 2015

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1134151657
  NPD
• Maxum Physical Therapy Inc

  • Physical Therapist
  • Placentia, CA
  • NPI 1629002936

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1699145987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S. PACENTIA AVE.",
            "address_2": "STE 100",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706832",
            "telephone_number": "714-646-8318",
            "fax_number": "714-646-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S. PACENTIA AVE.",
            "address_2": "STE 100",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706832",
            "telephone_number": "714-646-8318",
            "fax_number": "714-646-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "KATRINA JEAN",
        "middle_name": "MONDEJAR",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT15532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Woundology Corp
• Christy Wright
• Yalda Chiropractic Inc
• Gabriel Yalda, DC
• Carolann Yuriko Yamate, D.D.S.
• Amy Yi Pei Yang, M.D.
• Song Yang
• Alexi Yarashevich, NP
• Pancho Yarra
• Jay Wallace Yeager, COTA

• Occupational Therapist in Placentia, CA
• Providers in Placentia, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.