Active NPI
Jennie Pugh
- Occupational Therapy Assistant
- Concord, CA
National Provider Identifier
1063957306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 958
- Practice address
- 2300 Clayton Rd Suite 1170
Therapists Unlimited Genesis Healthcare Company
Concord, CA 94520 - Phone
- (925) 726-0166
- Fax
- (610) 347-4838
- NPI assigned
- Dec 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 958 | CA | Primary |
Addresses
Primary practice location
2300 Clayton Rd Suite 1170
Therapists Unlimited Genesis Healthcare Company
Concord, CA 94520
Mailing address
2300 Clayton Rd Suite 1170
Therapists Unlimited Genesis Healthcare Company
Concord, CA 94520
Phone (925) 726-0166
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 |
|---|---|---|---|
| 958 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482364800000",
"number": "1063957306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 CLAYTON RD SUITE 1170",
"address_2": "THERAPISTS UNLIMITED GENESIS HEALTHCARE COMPANY",
"city": "CONCORD",
"state": "CA",
"postal_code": "94520",
"telephone_number": "925-726-0166",
"fax_number": "610-347-4838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 CLAYTON RD SUITE 1170",
"address_2": "THERAPISTS UNLIMITED GENESIS HEALTHCARE COMPANY",
"city": "CONCORD",
"state": "CA",
"postal_code": "94520",
"telephone_number": "925-726-0166",
"fax_number": "610-347-4838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "JENNIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-22",
"last_updated": "2016-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.