Individual provider Active NPI

Oluwasola Olabode Aiyegbusi, OT/L

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1730516402
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
26749 Issued in CA
Practice address
342 Hauser Blvd
Los Angeles, CA 90036-5614
Phone
(510) 318-1314
NPI assigned
Sep 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 26749 CA Primary

Addresses

Primary practice location

342 Hauser Blvd
Los Angeles, CA 90036-5614

Mailing address

342 Hauser Blvd
Los Angeles, CA 90036-5614
Phone (510) 318-1314

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
26749CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1730516402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HAUSER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365614",
            "telephone_number": "510-318-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAUSER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365614",
            "telephone_number": "510-318-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIYEGBUSI",
        "first_name": "OLUWASOLA",
        "middle_name": "OLABODE",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "26749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.