Active NPI
Alphonso Butler, OT
- Contractor
- Redwood City, CA
National Provider Identifier
1134445125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 10771
- Practice address
- 1350 Saint Francis St
Redwood City, CA 94061-2145 - Phone
- (650) 219-9290
- NPI assigned
- Apr 15, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 10771 | CA | Primary |
Addresses
Primary practice location
1350 Saint Francis St
Redwood City, CA 94061-2145
Mailing address
1350 Saint Francis St
Redwood City, CA 94061-2145
Phone (650) 219-9290
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 |
|---|---|---|---|
| 10771 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431561600000",
"number": "1134445125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 SAINT FRANCIS ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940612145",
"telephone_number": "650-219-9290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 SAINT FRANCIS ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940612145",
"telephone_number": "650-219-9290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "ALPHONSO",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-15",
"last_updated": "2015-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "10771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.