Individual provider Active NPI

Brittany Noel Beverlin, COTA/L

  • Occupational Therapy Assistant
  • Redlands, CA
National Provider Identifier
1710703665
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
6995 Issued in CA
Practice address
757 W Redlands Blvd
Redlands, CA 92373-4641
Phone
(909) 783-1111
NPI assigned
Nov 25, 2024
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 6995 CA Primary

Addresses

Primary practice location

757 W Redlands Blvd
Redlands, CA 92373-4641

Mailing address

11663 Vista LN
Yucaipa, CA 92399-3520
Phone (951) 330-9134

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
6995CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Pediatrics CurrentSince Dec 1, 2024 Accepting new patients

Locations

757 W Redlands Blvd
Redlands, CA 92373
Phone (909) 783-1111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1710703665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11663 VISTA LN",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923993520",
            "telephone_number": "951-330-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734641",
            "telephone_number": "909-783-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERLIN",
        "first_name": "BRITTANY",
        "middle_name": "NOEL",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "6995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.