Active NPI
Andrea De Marino, MHS, OTR/L
- Pediatric Occupational Therapist
- Oceanside, CA
National Provider Identifier
1124149109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT10597
- Practice address
- 835 S Coast Hwy
Oceanside, CA 92054-4122 - Phone
- (760) 444-4733
- NPI assigned
- Apr 3, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 004431 | GA | |
| Pediatric Occupational Therapist | 225XP0200X | OT10597 | CA | Primary |
Addresses
Primary practice location
835 S Coast Hwy
Oceanside, CA 92054-4122
Mailing address
2507 Willenhall Way
Lithonia, GA 30058-3884
Other practice location 1
1244 Clairmont Rd Ste 224
Decatur, GA 30030-1260
Phone (404) 728-9766 ext. 11
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
| License | State | Type | Specialty |
|---|---|---|---|
| 004431 | GA | MD | Occupational Therapist |
| OT10597 | CA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sensory Solutions Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1124149109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2507 WILLENHALL WAY",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300583884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S COAST HWY",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920544122",
"telephone_number": "760-444-4733"
}
],
"practiceLocations": [
{
"address_1": "1244 Clairmont Rd Ste 224",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "GA",
"postal_code": "300301260",
"country_code": "US",
"telephone_number": "404-728-9766 x11",
"fax_number": "404-728-9166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE MARINO",
"first_name": "ANDREA",
"credential": "MHS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "004431",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "OT10597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.