Active NPI
Pattie Whitehurst, DPT,PT
- Physical Therapist
- San Leandro, CA
National Provider Identifier
1053705608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40292
- Practice address
- 13939 E 14TH St Ste 150
San Leandro, CA 94578-2601 - Phone
- (510) 343-8300
- NPI assigned
- Mar 21, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40292 | CA | Primary |
Addresses
Primary practice location
13939 E 14TH St Ste 150
San Leandro, CA 94578-2601
Mailing address
2432 McKinley Ave
Berkeley, CA 94703-1928
Phone (252) 367-0633
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40292 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426896000000",
"number": "1053705608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2432 MCKINLEY AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031928",
"telephone_number": "252-367-0633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13939 E 14TH ST STE 150",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782601",
"telephone_number": "510-343-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHURST",
"first_name": "PATTIE",
"credential": "DPT,PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-21",
"last_updated": "2015-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "40292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.