Lifeworks-Acs, Inc.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2330 Issued in CA

Legal business name

LIFEWORKS-ACS, INC.

Practice address

1755 W. Hammer Lane
Suite# 1
Stockton, CA 95209-2900

Phone

(209) 462-1598

Fax

(209) 942-0294

NPI assigned

Oct 29, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Mendel Alidio Uychutin, OTR/L

Title

President

Phone

(209) 462-1598

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1962702449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 W. HAMMER LANE",
            "address_2": "SUITE #1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 W. HAMMER LANE",
            "address_2": "SUITE# 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092900",
            "telephone_number": "209-462-1598",
            "fax_number": "209-942-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS-ACS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-29",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "UYCHUTIN",
        "authorized_official_first_name": "MENDEL",
        "authorized_official_middle_name": "ALIDIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-462-1598",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "4891",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "2330",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16503",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13292",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13231",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "9927",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "17406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.