Individual provider Active NPI

Lori Ann Tillotsonjahelka, COTA

  • Occupational Therapy Assistant
  • Rancho Palos Verdes, CA
National Provider Identifier
1962117465
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5630 Issued in CA
Practice address
6507 Sandy Point CT
Rancho Palos Verdes, CA 90275-5871
Phone
(310) 863-7491
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 5630 CA Primary

Addresses

Primary practice location

6507 Sandy Point CT
Rancho Palos Verdes, CA 90275-5871

Mailing address

6507 Sandy Point CT
Rancho Palos Verdes, CA 90275-5871
Phone (310) 863-7491

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
5630CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1962117465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 SANDY POINT CT",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755871",
            "telephone_number": "310-863-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 SANDY POINT CT",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755871",
            "telephone_number": "310-863-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSONJAHELKA",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.