Thera-Bridge

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

13092 Issued in CA

Legal business name

THERA-BRIDGE

Practice address

603 E Verdugo Ave Apt J
Burbank, CA 91501-2373

Phone

(818) 748-7066

NPI assigned

Aug 5, 2016

Organization subpart

No

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

Authorized official

Name

Mary Annthonette De Guzman

Title

Occupational Therapist

Phone

(818) 748-7066

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1831643949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 E VERDUGO AVE APT J",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E VERDUGO AVE APT J",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012373",
            "telephone_number": "818-748-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA-BRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "MARY ANNTHONETTE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "818-748-7066"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.