Individual provider Active NPI

Cynthia Cohan, PT

  • Pediatric Physical Therapist
  • San Mateo, CA
National Provider Identifier
1053725416
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
23943 Issued in CA
Practice address
1650 S Amphlett Blvd Ste 108
San Mateo, CA 94402-2514
Phone
(650) 638-9142
Fax
(650) 638-9141
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 23943 CA Primary

Addresses

Primary practice location

1650 S Amphlett Blvd Ste 108
San Mateo, CA 94402-2514

Mailing address

1204 Eureka CT
Los Altos, CA 94024-5555
Phone (408) 507-7472

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
23943CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1053725416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 EUREKA CT",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245555",
            "telephone_number": "408-507-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S AMPHLETT BLVD STE 108",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022514",
            "telephone_number": "650-638-9142",
            "fax_number": "650-638-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHAN",
        "first_name": "CYNTHIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "23943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.