Individual provider Active NPI

Yvette Paquin, O.T.

  • Pediatric Occupational Therapist
  • Ontario, CA
National Provider Identifier
1922480243
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 12007 Issued in CA
Practice address
855 N Euclid Ave
Ontario, CA 91762-2729
Phone
(909) 983-2020
Fax
(909) 983-6847
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT 12007 CA Primary

Addresses

Primary practice location

855 N Euclid Ave
Ontario, CA 91762-2729

Mailing address

855 N Euclid Ave
Ontario, CA 91762-2729
Phone (909) 983-2020

Other identifiers 1

IdentifierTypeStateIssuer
95-1946482MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT 12007CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1922480243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "YVETTE",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 12007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-1946482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.