Active NPI
Dixie Lynn Sudhakar, OTA
- Occupational Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1700145752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 1743
- Practice address
- 1930 S Beverly Glen Blvd
202
Los Angeles, CA 90025-5158 - Phone
- (717) 475-2642
- NPI assigned
- May 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA 1743 | CA | Primary |
Addresses
Primary practice location
1930 S Beverly Glen Blvd
202
Los Angeles, CA 90025-5158
Mailing address
1930 Beverly Glen Blvd
202
Los Angeles, CA 90025-0257
Phone (717) 475-2642
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA 1743 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336694400000",
"number": "1700145752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 BEVERLY GLEN BLVD",
"address_2": "202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900250257",
"telephone_number": "717-475-2642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 S BEVERLY GLEN BLVD",
"address_2": "202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900255158",
"telephone_number": "717-475-2642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDHAKAR",
"first_name": "DIXIE",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-11",
"last_updated": "2012-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "OTA 1743",
"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 May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.