NPIMap

Individual provider Active NPI

Luisito Arreola Nibungco, OTR/L

  • Occupational Therapist
  • Encino, CA
National Provider Identifier
1811181993
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 8772 Issued in CA
Practice address
16260 Ventura Blvd
Encino, CA 91436-2203
Phone
(818) 986-1977
NPI assigned
Aug 30, 2007
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31004188A IN
Occupational Therapist 225X00000X OT 8772 CA Primary

Addresses

Primary practice location

16260 Ventura Blvd
Encino, CA 91436-2203

Mailing address

16260 Ventura Blvd
Encino, CA 91436-2203

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

LicenseStateTypeSpecialty
OT 8772CAMDOccupational Therapist
31004188AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Pacific Past Accepting new patients
South Pacific Rehabilitation Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1811181993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362203",
            "telephone_number": "818-986-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBUNGCO",
        "first_name": "LUISITO",
        "middle_name": "ARREOLA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31004188A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 8772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.