Individual provider Active NPI

Adam Nicolas Utic

  • Occupational Therapy Assistant
  • San Diego, CA
National Provider Identifier
1043670540
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3411 Issued in CA
Practice address
7850 Mission Center CT
San Diego, CA 92108-1322
Phone
(619) 578-2232
Fax
(619) 578-2231
NPI assigned
Feb 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3411 CA Primary

Addresses

Primary practice location

7850 Mission Center CT
San Diego, CA 92108-1322

Mailing address

1574 Village View Rd
Encinitas, CA 92024-5606
Phone (760) 505-4313

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
3411CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1043670540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 VILLAGE VIEW RD",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245606",
            "telephone_number": "760-505-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 MISSION CENTER CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081322",
            "telephone_number": "619-578-2232",
            "fax_number": "619-578-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTIC",
        "first_name": "ADAM",
        "middle_name": "NICOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "3411",
            "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 Feb 26, 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.

Verify at the official NPI Registry.