Active NPI
Marissa Padilla Gonzalez, OTR/L
- Occupational Therapist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT210002092
- Practice address
- 5643 Copley Dr Ste 230
San Diego, CA 92111-7903 - Phone
- (858) 302-5665
- NPI assigned
- Dec 5, 2022
- 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 | OT210002092 | DC | Primary |
Addresses
Primary practice location
5643 Copley Dr Ste 230
San Diego, CA 92111-7903
Mailing address
5643 Copley Dr Ste 300
San Diego, CA 92111-7903
Phone (858) 455-9942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12386 Sycamore Ridge CT
San Diego, CA 92131-3227
Phone (858) 761-8101
5643 Copley Dr
Suite 230
San Diego, CA 92111-7903
Phone (858) 302-5665
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT210002092 | DC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortho 1 Medical Group | Current | Accepting new patients | |
| Mission Occupational and Hand Therapy Services Apc | Current | Accepting new patients | |
| Emily Jeter Otrl MSPT CHT Inc | Occupational Therapist | Past | Accepting new patients |
Locations
9834 Genesee Ave
Ste 228
La Jolla, CA 92037
Phone (858) 455-9942
5643 Copley Dr
Ste 230
San Diego, CA 92111
Phone (858) 302-5665
9988 Hibert St
Ste 208
San Diego, CA 92131
Phone (858) 227-7229
5643 Copley Dr
Ste 300
San Diego, CA 92111
Phone (858) 455-9942
230 Prospect Pl
Ste 230
San Diego, CA 92118
Phone (619) 435-7282
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hand Occupational Therapist
- San Diego, CA
- NPI 1073117925
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1609471929
-
- Physical Rehabilitation Occupational Therapist
- Washington, DC
- NPI 1891176418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746057600000",
"number": "1043920770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5643 COPLEY DR STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921117903",
"telephone_number": "858-455-9942",
"fax_number": "858-455-6473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5643 COPLEY DR STE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921117903",
"telephone_number": "858-302-5665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MARISSA",
"middle_name": "PADILLA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2025-05-01",
"certification_date": "2025-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "DC",
"license": "OT210002092",
"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 May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.