Joyride Therapeutic Adventures

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

JOYRIDE THERAPEUTIC ADVENTURES

Practice address

3064 Thorn St
San Diego, CA 92104-4639

Phone

(610) 996-6036

NPI assigned

Mar 12, 2020

Organization subpart

No

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

Authorized official

Name

Beth Kelly, MOT, OTR/L

Title

Occupational Therapist/ Co-Founder

Phone

(610) 996-6036

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1104452978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3064 THORN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044639",
            "telephone_number": "610-996-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 THORN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044639",
            "telephone_number": "610-996-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYRIDE THERAPEUTIC ADVENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/ CO-FOUNDER",
        "authorized_official_telephone_number": "610-996-6036",
        "authorized_official_credential": "MOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.