Active NPI
Kassandra Edith Cruz, COTA
- Occupational Therapy Assistant
- Laredo, TX
National Provider Identifier
1104515691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 216750
- Practice address
- 2110 Lomas del Sur
Laredo, TX 78046-5750 - Phone
- (956) 712-9111
- NPI assigned
- May 2, 2023
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 216750 | TX | Primary |
Addresses
Primary practice location
2110 Lomas del Sur
Laredo, TX 78046-5750
Mailing address
3304 Santa Maria Ave
Laredo, TX 78040-1203
Phone (956) 652-1025
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 |
|---|---|---|---|
| 216750 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1104515691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3304 SANTA MARIA AVE",
"city": "LAREDO",
"state": "TX",
"postal_code": "780401203",
"telephone_number": "956-652-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 LOMAS DEL SUR",
"city": "LAREDO",
"state": "TX",
"postal_code": "780465750",
"telephone_number": "956-712-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "KASSANDRA",
"middle_name": "EDITH",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-02",
"last_updated": "2023-05-02",
"certification_date": "2021-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "216750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.