Individual provider Active NPI

Sandra L Avina, OT

  • Occupational Therapist
  • Cathedral City, CA
National Provider Identifier
1861256190
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3790 Issued in CA
Practice address
69472 Serenity Rd
Cathedral City, CA 92234-7921
Phone
(760) 409-6383
Fax
(866) 225-9947
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3790 CA Primary

Addresses

Primary practice location

69472 Serenity Rd
Cathedral City, CA 92234-7921

Mailing address

41204 Redhawk St
Indio, CA 92203-3023
Phone (760) 625-2750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226002354 CA Practitioner - Occupational Therapist in Private Practice 4284079633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On the Move RehabGroup PAC ID 6709195316, 28 clinicians

Practice addresses (Care Compare)

69472 Serenity Rd
Cathedral City, CA 92234-7921
Phone (760) 409-6383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3790CAMDAcupuncturist
OT3790CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
On the Move Rehab Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1861256190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41204 REDHAWK ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922033023",
            "telephone_number": "760-625-2750",
            "fax_number": "866-225-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69472 SERENITY RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347921",
            "telephone_number": "760-409-6383",
            "fax_number": "866-225-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVINA",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT3790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.