Individual provider Active NPI

Dairian Monique Roberts, OTR/L, IBCLC

  • Lactation Consultant (Non-RN)
  • Carson, CA
National Provider Identifier
1790111086
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
Practice address
637 E Albertoni St Ste 108
Carson, CA 90746-1543
Phone
(310) 845-5173
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT13769 CA
Doula 374J00000X
Lactation Consultant (Non-RN) 174N00000X Primary

Addresses

Primary practice location

637 E Albertoni St Ste 108
Carson, CA 90746-1543

Mailing address

704 Colorado Cir
Carson, CA 90745-2871
Phone (310) 817-1191

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT13769CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Humbled by Motherhood Inc. Lactation Consultant, Non-RN CurrentSince Jan 21, 2024 Accepting new patients
Recovercare Therapy Group, Inc. Past Accepting new patients
Recovercare Therapy Group, Inc. Past Accepting new patients

Locations

637 E Albertoni St
Ste 108
Carson, CA 90746
Phone (310) 845-5173

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1790111086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 COLORADO CIR",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452871",
            "telephone_number": "310-817-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 E ALBERTONI ST STE 108",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461543",
            "telephone_number": "310-845-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DAIRIAN",
        "middle_name": "MONIQUE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT13769",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.