Individual provider Active NPI

Kirti Maria Dsouza, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • San Jose, CA
National Provider Identifier
1053648287
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8693 Issued in CA
Practice address
1267 Meridian Ave
San Jose, CA 95125
Phone
(971) 206-5200
Fax
(971) 206-5203
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT8693 CA Primary

Addresses

Primary practice location

1267 Meridian Ave
San Jose, CA 95125

Mailing address

4560 SE International Way
Ste 100
Milwaukie, OR 97222
Phone (971) 206-5200

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
OT8693CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1053648287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95125",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DSOUZA",
        "first_name": "KIRTI",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT8693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.