Individual provider Active NPI

Terence Abram, COTA/L

  • Occupational Therapy Assistant
  • La Mesa, CA
National Provider Identifier
1740745975
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4713 Issued in CA
Practice address
5696 Lake Murray Blvd
La Mesa, CA 91942-1929
Phone
(619) 460-7871
NPI assigned
Feb 1, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 409743 CA
Occupational Therapy Assistant 224Z00000X 4713 CA Primary

Addresses

Primary practice location

5696 Lake Murray Blvd
La Mesa, CA 91942-1929

Mailing address

7645 Pacific Ave Apt 37
Lemon Grove, CA 91945-2443
Phone (909) 731-1917

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
409743CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1740745975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 PACIFIC AVE APT 37",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452443",
            "telephone_number": "909-731-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5696 LAKE MURRAY BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421929",
            "telephone_number": "619-460-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAM",
        "first_name": "TERENCE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-01",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "409743",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "4713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.