Active NPI
Carissa Lee
- Occupational Therapist
- Riverside, CA
National Provider Identifier
1992256747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 16353
- Practice address
- 6177 River Crest Dr
A
Riverside, CA 92507-0728 - Phone
- (951) 653-4480
- Fax
- (951) 653-5051
- NPI assigned
- Oct 17, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 16353 | CA | Primary |
Addresses
Primary practice location
6177 River Crest Dr
A
Riverside, CA 92507-0728
Mailing address
6177 River Crest Dr
A
Riverside, CA 92507-0728
Phone (951) 653-4480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16353 | Other | CA | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16353 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1992256747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6177 RIVER CREST DR",
"address_2": "A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070728",
"telephone_number": "951-653-4480",
"fax_number": "951-653-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6177 RIVER CREST DR",
"address_2": "A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070728",
"telephone_number": "951-653-4480",
"fax_number": "951-653-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-17",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "16353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "16353",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.