Individual provider Active NPI

Caesar Jovellana Ciruela, OT

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1144744269
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8622 Issued in CA
Practice address
2751 Roosevelt Rd Ste 203
San Diego, CA 92106-6180
Phone
(619) 501-9755
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT8622 CA Primary

Addresses

Primary practice location

2751 Roosevelt Rd Ste 203
San Diego, CA 92106-6180

Mailing address

3760 Convoy St Ste 204
San Diego, CA 92111-3744
Phone (858) 514-0375

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

LicenseStateTypeSpecialty
OT8622CAMDOccupational Therapist
8622CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1144744269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113744",
            "telephone_number": "858-514-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ROOSEVELT RD STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066180",
            "telephone_number": "619-501-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRUELA",
        "first_name": "CAESAR",
        "middle_name": "JOVELLANA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT8622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 31, 2017; 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.