Individual provider Active NPI

Fredlyn Sue Berger, OT

  • Occupational Therapist
  • North Hollywood, CA
National Provider Identifier
1720195043
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1781 Issued in CA
Practice address
6400 Laurel Canyon Blvd
Suite # 400
North Hollywood, CA 91606-1559
Phone
(818) 763-0136
Fax
(818) 763-3838
NPI assigned
Aug 23, 2006
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1781 CA Primary
Hand Occupational Therapist 225XH1200X 1781 CA
Pediatric Occupational Therapist 225XP0200X OT1781 CA

Addresses

Primary practice location

6400 Laurel Canyon Blvd
Suite # 400
North Hollywood, CA 91606-1559

Mailing address

6400 Laurel Canyon Blvd
Suite # 600
North Hollywood, CA 91606-1559
Phone (818) 760-0501

Other identifiers 1

IdentifierTypeStateIssuer
OT1781OtherCACA LICENE

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
OT1781CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Every Child Achieves, Inc Occupational Therapist Past Accepting new patients
Wellness Works, Inc. Occupational Therapist PastSince Apr 1, 2013 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, 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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1720195043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 LAUREL CANYON BLVD",
            "address_2": "SUITE # 600",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061559",
            "telephone_number": "818-760-0501",
            "fax_number": "818-763-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 LAUREL CANYON BLVD",
            "address_2": "SUITE # 400",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061559",
            "telephone_number": "818-763-0136",
            "fax_number": "818-763-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "FREDLYN",
        "middle_name": "SUE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "1781",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "1781",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT1781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENE",
            "identifier": "OT1781",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.