Randy Balbuena
Individual provider Active NPI Occupational Therapist · Diamond Bar, CA
NPI 1760920722 · NPPES record last updated Feb 9, 2017
Key facts
- NPI
- 1760920722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 10294 (CA)
- Practice address
- 682 Armitos PL
Diamond Bar, CA 91765-1863 - Phone
- (909) 610-0828
- NPI assigned
- Feb 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10294 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10294 | CA | Yes |
Addresses
Primary practice location
682 Armitos PL
Diamond Bar, CA 91765-1863
Mailing address
682 Armitos PL
Diamond Bar, CA 91765-1863
Other providers in Diamond Bar, CA
- Avzo LLC
- Katherine Anne Baca
- Heasuk Bae
- Claudia Baettig
- Sushma Bahl
- Carey Balderrama
- Thomas Strand Ball
- Ruby Banuelos Calhoun
- Douglas L Barcon
- Lizbeth Barragan
All providers in Diamond Bar, CA · Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.