Individual provider Active NPI

Nicole Rae Mariscal, COTA/L

  • Occupational Therapy Assistant
  • Bellflower, CA
National Provider Identifier
1700369592
Registry record updated Sep 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4453 Issued in CA
Practice address
17042 Bellflower Blvd
Bellflower, CA 90706-5950
Phone
(562) 991-1324
NPI assigned
Sep 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4453 CA Primary

Addresses

Primary practice location

17042 Bellflower Blvd
Bellflower, CA 90706-5950

Mailing address

17042 Bellflower Blvd
Bellflower, CA 90706-5950
Phone (562) 991-1324

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

LicenseStateTypeSpecialty
4453CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1700369592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17042 BELLFLOWER BLVD",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065950",
            "telephone_number": "562-991-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17042 BELLFLOWER BLVD",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065950",
            "telephone_number": "562-991-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISCAL",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "4453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.