Individual provider Active NPI

Tracy Jalaba, OT

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1902145022
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT14814 Issued in CA
Practice address
1640 Marengo St
Suite 500
Los Angeles, CA 90033-1036
Phone
(323) 442-3340
NPI assigned
Feb 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Occupational Therapist 225X00000X OT14814 CA Primary

Addresses

Primary practice location

1640 Marengo St
Suite 500
Los Angeles, CA 90033-1036

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-3340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tracy.jalaba@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810000547 CA Practitioner - Occupational Therapist in Private Practice 4082908306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1031 W 34TH St
Los Angeles, CA 90089-3621
Phone (213) 821-6500

1441 Eastlake Ave
Suite 5409
Los Angeles, CA 90033-1036
Phone (323) 865-0563

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1640 Marengo St
Los Angeles, CA 90033-1036
Phone (323) 223-4091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT14814CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2016 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2016 Accepting new patients
Usc Occupational Therapy Faculty Practice, Inc. Occupational Therapist Past Accepting new patients

Locations

1031 W 34th St
Los Angeles, CA 90089
Phone (213) 740-7711

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2250 Alcazar St
Ste 133
Los Angeles, CA 90089
Phone (323) 442-3340

1640 Marengo St
Ste 500
Los Angeles, CA 90033
Phone (323) 442-3340

1640 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4091

830 S Flower St
#B100
Los Angeles, CA 90017

830 S Flower St
Los Angeles, CA 90017
Phone (213) 437-1007

Organizations & group practices 3

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": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1902145022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MARENGO ST",
            "address_2": "SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331036",
            "telephone_number": "323-442-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALABA",
        "first_name": "TRACY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT14814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.jalaba@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1640 Marengo St",
            "address_2": "Suite 500",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900331036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.