Individual provider Active NPI

Monique Eliana Ruddell, OTD, OTR/L, CHT

  • Hand Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1710312038
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT13120 Issued in CA
Practice address
5901 W Olympic Blvd Ste 407
Los Angeles, CA 90036-4669
Phone
(323) 917-5194
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT13120 CA Primary

Addresses

Primary practice location

5901 W Olympic Blvd Ste 407
Los Angeles, CA 90036-4669

Mailing address

5901 W Olympic Blvd Ste 407
Los Angeles, CA 90036-4669
Phone (323) 917-5194

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT13120CAMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1710312038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD STE 407",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364669",
            "telephone_number": "323-917-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD STE 407",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364669",
            "telephone_number": "323-917-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDELL",
        "first_name": "MONIQUE",
        "middle_name": "ELIANA",
        "name_prefix": "Ms.",
        "credential": "OTD, OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT13120",
            "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 Mar 12, 2019; 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.