Elisabeth Renee Bolten, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

24158 Issued in CA

Practice address

11460 W Washington Blvd
Los Angeles, CA 90066-6030

Phone

(310) 337-7115

Fax

(310) 216-6153

NPI assigned

Sep 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Therapy West, Inc

  • Occupational Therapist
  • Los Angeles, CA
  • NPI 1225232523
  NPD

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1881317907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 W 85TH ST",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902938405",
            "telephone_number": "310-903-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11460 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666030",
            "telephone_number": "310-337-7115",
            "fax_number": "310-216-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTEN",
        "first_name": "ELISABETH",
        "middle_name": "RENEE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "24158",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "24158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bolos
• Veronica Bolotnikova
• Nina Bolour
• Pejman Bolourian, MD
• Agnes Bolt, PMHNP, RN
• Alyssa Marie Bolter, MS, PA-C
• Deborah Bolton, NP
• Masai Bolton
• Lucie Bolzan
• Bomamed Inc

• Occupational Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.