Jesus Guadalupe Landeros

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5783 Issued in CA

Practice address

8112 Cypress Ave
South Gate, CA 90280-2203

Phone

(323) 536-4749

NPI assigned

May 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1710625629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 CYPRESS AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802203",
            "telephone_number": "323-536-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 CYPRESS AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802203",
            "telephone_number": "323-536-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEROS",
        "first_name": "JESUS",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "8112 Cypress Ave",
            "city": "South Gate",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902802203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapy Assistant in South Gate, CA
• Providers in South Gate, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.