Active NPI
Jikko Joven Bautista Del Rosario
- Occupational Therapy Assistant
- Fontana, CA
National Provider Identifier
1700583721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4923
- Practice address
- 8207 Laurel Ave
Fontana, CA 92335-3723 - Phone
- (626) 824-6144
- NPI assigned
- Feb 9, 2023
- Sex
- Male
- 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 | 4923 | CA | Primary |
Addresses
Primary practice location
8207 Laurel Ave
Fontana, CA 92335-3723
Mailing address
8207 Laurel Ave
Fontana, CA 92335-3723
Phone (626) 824-6144
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1700583721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8207 LAUREL AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923353723",
"telephone_number": "626-824-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8207 LAUREL AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923353723",
"telephone_number": "626-824-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEL ROSARIO",
"first_name": "JIKKO JOVEN",
"middle_name": "BAUTISTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-09",
"last_updated": "2023-02-09",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "4923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.