Individual provider Active NPI

Olena Shuprudko, COTA/L

  • Occupational Therapy Assistant
  • Elk Grove, CA
National Provider Identifier
1730098393
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4006 Issued in CA
Practice address
9673 Lakepoint Dr
Elk Grove, CA 95758-3615
Phone
(916) 683-4096
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 4006 CA Primary

Addresses

Primary practice location

9673 Lakepoint Dr
Elk Grove, CA 95758-3615

Mailing address

815 Bryte Ave Apt 61
West Sacramento, CA 95605-1852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1730098393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 BRYTE AVE APT 61",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9673 LAKEPOINT DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957583615",
            "telephone_number": "916-683-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPRUDKO",
        "first_name": "OLENA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "4006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.