Transformative Physical Rehab LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

TRANSFORMATIVE PHYSICAL REHAB LLC

Practice address

230 S Altadena Dr
Pasadena, CA 91107-4820

Phone

(626) 297-0658

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

Katrin Mutiany Izumi, OTR/L

Title

Occupational Therapist/Owner

Phone

(626) 297-0658

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1770103467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 CONDON AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783402",
            "telephone_number": "626-297-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S ALTADENA DR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074820",
            "telephone_number": "626-297-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIVE PHYSICAL REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "IZUMI",
        "authorized_official_first_name": "KATRIN",
        "authorized_official_middle_name": "MUTIANY",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "626-297-0658",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.