Active NPI
Jonathan Dara Heng, OTD
- Occupational Therapist
- Moreno Valley, CA
National Provider Identifier
1780332379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 21332
- Practice address
- 23180 Hemlock Ave Ste 100
Moreno Valley, CA 92557-8001 - Phone
- (951) 266-9880
- Fax
- (951) 289-7964
- NPI assigned
- Mar 14, 2022
- Sex
- Male
- 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 Therapist | 225X00000X | 21332 | CA | Primary |
Addresses
Primary practice location
23180 Hemlock Ave Ste 100
Moreno Valley, CA 92557-8001
Mailing address
23180 Hemlock Ave Ste 100
Moreno Valley, CA 92557-8001
Phone (951) 266-9880
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 |
|---|---|---|---|
| 21332 | CA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1780332379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23180 HEMLOCK AVE STE 100",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925578001",
"telephone_number": "951-266-9880",
"fax_number": "951-289-7964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23180 HEMLOCK AVE STE 100",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925578001",
"telephone_number": "951-266-9880",
"fax_number": "951-289-7964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENG",
"first_name": "JONATHAN",
"middle_name": "DARA",
"name_prefix": "Dr.",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-14",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "21332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.