Brianna Michelle Fine, MSOT, OTR/L, CPAM

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT11399 Issued in CA

Practice address

1955 Lomita Blvd
Lomita, CA 90717-1807

Phone

(310) 325-1970

NPI assigned

Aug 31, 2017

Last updated

Aug 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Brianna Michelle Butler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1932627700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S PATTON AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313429",
            "telephone_number": "310-429-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 LOMITA BLVD",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907171807",
            "telephone_number": "310-325-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "BRIANNA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MSOT, OTR/L, CPAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT11399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "OT11399",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "BUTLER",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "credential": "MSOT, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Lomita, CA
• Providers in Lomita, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.