Annie L Bustamante, OTR/L

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

License

28539 Issued in CA

Practice address

1420 S. Milliken Avenue
Suite 508
Ontario, CA 91761

Phone

(909) 988-2418

NPI assigned

Nov 10, 2019

Reactivated

Mar 10, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1932744331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9027 FERNDALE AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356017",
            "telephone_number": "909-343-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S. MILLIKEN AVENUE",
            "address_2": "SUITE 508",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "909-988-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "ANNIE",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "deactivation_date": "2026-03-05",
        "reactivation_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "CA",
            "license": "28539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stella Busche
• Ammanda Bush, M.S. BCBA
• Gilbert Alfort Bush, MEDICAL DOCTOR
• Bridget Bushong, SLP
• Tatiana Busse
• Marysol Bustamante
• Stephany Bustamante
• Alexandra Bustos
• Alexandra Celene Bustos
• Gabrielle Bustos

• Mental Health Occupational Therapist in Ontario, CA
• Providers in Ontario, CA by specialty
• Mental Health Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.