Individual provider Active NPI

Johan S Ross-Holland, OTR

  • Occupational Therapist
  • Palmdale, CA
National Provider Identifier
1902526189
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
23192 Issued in CA
Practice address
40233 Wyngate CT
Palmdale, CA 93551-7538
Phone
(166) 199-2626
NPI assigned
Aug 30, 2022
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 23192 CA Primary

Addresses

Primary practice location

40233 Wyngate CT
Palmdale, CA 93551-7538

Mailing address

40233 Wyngate CT
Palmdale, CA 93551-7538
Phone (166) 199-2626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220930001404 CA Practitioner - Occupational Therapist in Private Practice 0749666592 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23192CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc CurrentSince Sep 1, 2022 Accepting new patients
Insync Occupational Therapy Occupational Therapist CurrentSince Aug 25, 2024 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Sep 1, 2022 Accepting new patients
Nurture Therapy Group, an Occupational Therapy Corporation Occupational Therapist CurrentSince Sep 8, 2023 Accepting new patients

Locations

305 Davenport St
Camarillo, CA 93012

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

44215 15th St W
Ste 215
Lancaster, CA 93534
Phone (661) 609-5510

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 488-6340

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1902526189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40233 WYNGATE CT",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935517538",
            "telephone_number": "166-199-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40233 WYNGATE CT",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935517538",
            "telephone_number": "166-199-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS-HOLLAND",
        "first_name": "JOHAN",
        "middle_name": "S",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "23192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.