Ana Cecilia Alfonso, OTR
Individual provider Active NPI Occupational Therapist · Baldwin Park, CA
NPI 1902000193 · NPPES record last updated Nov 30, 2021
Key facts
- NPI
- 1902000193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 204 (CA)
- Practice address
- 1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806 - Phone
- (626) 851-5549
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100521000781 | CA | Practitioner - Occupational Therapist in Private Practice | 2163551615 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204 | CA | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 204 | CA | Yes |
Addresses
Primary practice location
1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Mailing address
1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-5549
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Baldwin Park, CA
- Roohe Ahmed
- Eduardo Ajuria
- Bassem Akhnoukh
- Peter Garcia Alarcio
- Basheer Alas
- Baber H. Ali
- Susan Ung Almazan
- Roberto Alonso
- Cesar C. Alonzo
- Celina Alpuerto Marchena
All providers in Baldwin Park, CA · Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.