Active NPI
Lisa Harris, COTA
- Occupational Therapy Assistant
- Glendale, CA
National Provider Identifier
1881083822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2072
- Practice address
- 330 Mission Road
Glendale, CA 91205 - Phone
- (818) 247-4476
- NPI assigned
- Jan 14, 2015
- Last updated
- Jan 14, 2015
- Sex
- Female
- 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 Therapy Assistant | 224Z00000X | 2072 | CA | Primary |
Addresses
Primary practice location
330 Mission Road
Glendale, CA 91205
Mailing address
10756 Blix St
Apt 209
North Hollywood, CA 91602-1367
Phone (616) 915-6133
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 |
|---|---|---|---|
| 2072 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421193600000",
"number": "1881083822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10756 BLIX ST",
"address_2": "APT 209",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916021367",
"telephone_number": "616-915-6133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MISSION ROAD",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91205",
"telephone_number": "818-247-4476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "LISA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-14",
"last_updated": "2015-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "2072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.