Individual provider Active NPI

Margaret Ann Fuller

  • Physical Rehabilitation Occupational Therapist
  • San Diego, CA
National Provider Identifier
1003449422
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT2048 Issued in CA
Practice address
15004 Innovation Dr
San Diego, CA 92128-3491
Phone
(858) 605-7189
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OT2048 CA Primary

Addresses

Primary practice location

15004 Innovation Dr
San Diego, CA 92128-3491

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 704-5612

Other practice location 1

2205 Vista Way
Oceanside, CA 92054-5661
Phone (760) 704-5600

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

LicenseStateTypeSpecialty
OT2048CAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1003449422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-704-5612",
            "fax_number": "858-404-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283491",
            "telephone_number": "858-605-7189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Vista Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920545661",
            "country_code": "US",
            "telephone_number": "760-704-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MARGARET",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "OT2048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.