Individual provider Active NPI

Adriana Beacon, PT

  • Physical Therapist
  • Pleasanton, CA
National Provider Identifier
1073675237
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20394 Issued in CA
Practice address
5720 Stoneridge Mall Rd
Suite 390
Pleasanton, CA 94588-2828
Phone
(925) 847-5366
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20394 CA Primary

Addresses

Primary practice location

5720 Stoneridge Mall Rd
Suite 390
Pleasanton, CA 94588-2828

Mailing address

5720 Stoneridge Mall Rd
Suite 390
Pleasanton, CA 94588-2828
Phone (925) 847-5366

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20394CAMDClinical Psychologist
PT20394CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1073675237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD",
            "address_2": "SUITE 390",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882828",
            "telephone_number": "925-847-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD",
            "address_2": "SUITE 390",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882828",
            "telephone_number": "925-847-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACON",
        "first_name": "ADRIANA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.