Edner Banal Estrella

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

3824 Issued in CA

Practice address

201 Allen Ave
Glendale, CA 91201-2803

Phone

(818) 845-8507

NPI assigned

Dec 12, 2019

Last updated

Dec 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1942848759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24307 VERDUGO CIR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913544401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ALLEN AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012803",
            "telephone_number": "818-845-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRELLA",
        "first_name": "EDNER",
        "middle_name": "BANAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "3824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Glendale, CA
• Providers in Glendale, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.