NPIMap

Individual provider Active NPI

Priscilla Park

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1932447232
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12142 Issued in CA
Practice address
11500 Nimitz Ave
Los Angeles, CA 90049-3566
Phone
(760) 242-3963
Fax
(760) 242-1066
NPI assigned
Jan 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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 OT12142 CA Primary

Addresses

Primary practice location

11500 Nimitz Ave
Los Angeles, CA 90049-3566

Mailing address

11500 Nimitz Ave
Los Angeles, CA 90049-3566
Phone (760) 242-3963

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RPM Rebah, Inc Past Accepting new patients
RPM Rehab Inc Past Accepting new patients
RPM Rehab, Inc. Past Accepting new patients
Adi Rehab, Incorporated PastSince Nov 24, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1932447232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 NIMITZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493566",
            "telephone_number": "760-242-3963",
            "fax_number": "760-242-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 NIMITZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493566",
            "telephone_number": "760-242-3963",
            "fax_number": "760-242-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PRISCILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT12142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 21, 2013; 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.