Active NPI
Pamela Modeste, RDT, MS
- Drama Therapist
- Los Angeles, CA
National Provider Identifier
1730831736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Drama Therapist
- License
- 686
- Practice address
- 1073 N Alma Ave
Los Angeles, CA 90063-2731 - Phone
- (213) 422-1393
- NPI assigned
- Jan 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Drama Therapist | 101200000X | 686 | Primary |
Addresses
Primary practice location
1073 N Alma Ave
Los Angeles, CA 90063-2731
Mailing address
1001 Wilshire Blvd Ste 2177
Los Angeles, CA 90017-2415
Phone (213) 422-1393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686 | Other | NADTA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | thescenedramaworks.com/contact | Direct |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1730831736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 WILSHIRE BLVD STE 2177",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900172415",
"telephone_number": "213-422-1393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1073 N ALMA AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900632731",
"telephone_number": "213-422-1393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODESTE",
"first_name": "PAMELA",
"credential": "RDT, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-20",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101200000X",
"taxonomy_group": "",
"desc": "Drama Therapist",
"state": null,
"license": "686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NADTA",
"identifier": "686",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "thescenedramaworks.com/contact",
"affiliation": "N",
"endpointDescription": "website contact page",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email address",
"address_1": "1073 N Alma Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900632731",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.