Individual provider Active NPI

Haylie King

  • Pediatric Occupational Therapist
  • Cypress, CA
National Provider Identifier
1720590417
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT17994 Issued in CA
Practice address
11205 Knott Ave Ste E
Cypress, CA 90630-5489
Phone
(714) 893-7399
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT17994 CA Primary

Addresses

Primary practice location

11205 Knott Ave Ste E
Cypress, CA 90630-5489

Mailing address

11205 Knott Ave Ste E
Cypress, CA 90630-5489
Phone (714) 893-7399

Other identifiers 1

IdentifierTypeStateIssuer
OT17994OtherCABOARD OF OCCUPATIONAL THERAPY OF CALIFORNIA

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
OT17994CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pediatric Physical Therapy, Inc Pediatrics PastSince Oct 12, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1720590417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 KNOTT AVE STE E",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305489",
            "telephone_number": "714-893-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 KNOTT AVE STE E",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305489",
            "telephone_number": "714-893-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "HAYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT17994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF OCCUPATIONAL THERAPY OF CALIFORNIA",
            "identifier": "OT17994",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.