Active NPI
Victoria Boettger, MOT
- Occupational Therapist
- San Diego, CA
National Provider Identifier
1124622485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 23930
- Practice address
- 4100 Normal St
San Diego, CA 92103-2653 - Phone
- (619) 725-5501
- NPI assigned
- Nov 27, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 23930 | CA | Primary |
| Occupational Therapist | 225X00000X | OTLL-000028 | AZ |
Addresses
Primary practice location
4100 Normal St
San Diego, CA 92103-2653
Mailing address
27212 N 53Rd Ave
Phoenix, AZ 85083-7329
Phone (480) 939-4097
Other practice location 1
2302 N 15th Ave
Phoenix, AZ 85007-1201
Phone (623) 242-6908
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23930 | Other | CA | CALIFORNIABOARDOFOCCUPATIONALTHERAPY |
| OTLL-000028 | Other | AZ | ARIZONA BOARD OF OCCUPATIONAL THERAPY EXAMINERS |
Other names 1
- Ms. Victoria Gabriella Wymer
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 |
|---|---|---|---|
| OTLL-000028 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1124622485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27212 N 53RD AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850837329",
"telephone_number": "480-939-4097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 NORMAL ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032653",
"telephone_number": "619-725-5501"
}
],
"practiceLocations": [
{
"address_1": "2302 N 15th Ave",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850071201",
"country_code": "US",
"telephone_number": "623-242-6908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOETTGER",
"first_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "MOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-27",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "23930",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTLL-000028",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIABOARDOFOCCUPATIONALTHERAPY",
"identifier": "23930",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA BOARD OF OCCUPATIONAL THERAPY EXAMINERS",
"identifier": "OTLL-000028",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VICTORIA",
"last_name": "WYMER",
"middle_name": "GABRIELLA",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.