Individual provider Active NPI

Claudia Marie Otis, BA, CATC III

  • Addiction (Substance Use Disorder) Counselor
  • Anaheim, CA
National Provider Identifier
1710312590
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
101966 III Issued in CA
Practice address
321 N State College Blvd
Anaheim, CA 92806-2915
Phone
(714) 687-0077
Fax
(714) 687-0691
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 101966 III CA Primary

Addresses

Primary practice location

321 N State College Blvd
Anaheim, CA 92806-2915

Mailing address

321 N State College Blvd
Anaheim, CA 92806-2915
Phone (714) 687-0077

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
101966 IIICAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Alcohol & Drug Programs, Inc. Past Accepting new patients
Heritage House North Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1710312590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062915",
            "telephone_number": "714-687-0077",
            "fax_number": "714-687-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062915",
            "telephone_number": "714-687-0077",
            "fax_number": "714-687-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "CLAUDIA",
        "middle_name": "MARIE",
        "credential": "BA, CATC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "101966 III",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.