Irina Igorevna Rudometkina, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5255 Issued in CA

Practice address

3498 Green Valley Rd
Rescue, CA 95672-9625

Phone

(530) 391-8670

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1881286730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 FOURNESS DR",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052225",
            "telephone_number": "916-477-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3498 GREEN VALLEY RD",
            "city": "RESCUE",
            "state": "CA",
            "postal_code": "956729625",
            "telephone_number": "530-391-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOMETKINA",
        "first_name": "IRINA",
        "middle_name": "IGOREVNA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rescue Fire Protection District
• Rescue Union Elementary District
• Sydney Rivera, M.A., CF-SLP
• Candace Ro
• Isabella Romano, MS, OTR/L
• Zenzele Shakir, M.S., CCC-SLP
• Hui-Ni Shen
• Sandra Lynne Singleton, ED.D. SLP CCC
• Jennifer Stucki, OTR/L
• Bronwyn Szignarowitz, D.V.M., M.P.V.M.

• Occupational Therapy Assistant in Rescue, CA
• Providers in Rescue, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.