Active NPI
Abeer Otaky, CCC-SLP
- Speech-Language Pathologist
- Arcadia, CA
National Provider Identifier
1972190957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 33154
- Practice address
- 301 E Foothill Blvd
Arcadia, CA 91006-2549 - Phone
- (626) 538-2751
- NPI assigned
- Dec 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 15289 | CA | |
| Speech-Language Pathologist | 235Z00000X | 33154 | CA | Primary |
Addresses
Primary practice location
301 E Foothill Blvd
Arcadia, CA 91006-2549
Mailing address
301 E Foothill Blvd
Arcadia, CA 91006-2549
Phone (909) 524-2104
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33154 | Other | CA | SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD |
| 15289 | Other | CA | SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33154 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1972190957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E FOOTHILL BLVD",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910062549",
"telephone_number": "909-524-2104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E FOOTHILL BLVD",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910062549",
"telephone_number": "626-538-2751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTAKY",
"first_name": "ABEER",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-24",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "15289",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "33154",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD",
"identifier": "33154",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD",
"identifier": "15289",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.