Active NPI
Angela Divinagracia, COTA
- Occupational Therapy Assistant
- Brea, CA
National Provider Identifier
1760912679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3737
- Practice address
- 500 W Central Ave Ste B
Brea, CA 92821-3036 - Phone
- (714) 529-5022
- NPI assigned
- Jun 13, 2017
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3737 | CA | Primary |
Addresses
Primary practice location
500 W Central Ave Ste B
Brea, CA 92821-3036
Mailing address
11252 Vista LN
El Monte, CA 91731-1456
Phone (562) 370-7429
Other practice location 1
14532 Central Ave
Chino, CA 91710-9508
Phone (909) 597-0504
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3737 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1760912679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11252 VISTA LN",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917311456",
"telephone_number": "562-370-7429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W CENTRAL AVE STE B",
"city": "BREA",
"state": "CA",
"postal_code": "928213036",
"telephone_number": "714-529-5022"
}
],
"practiceLocations": [
{
"address_1": "14532 Central Ave",
"address_purpose": "LOCATION",
"city": "Chino",
"state": "CA",
"postal_code": "917109508",
"country_code": "US",
"telephone_number": "909-597-0504",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIVINAGRACIA",
"first_name": "ANGELA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "3737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.