Individual provider Active NPI

Kristen Moriarty, OT

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1164747416
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8378 Issued in CA
Practice address
3760 Convoy St
204
San Diego, CA 92111-3742
Phone
(858) 514-0375
NPI assigned
Mar 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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 8378 CA Primary

Addresses

Primary practice location

3760 Convoy St
204
San Diego, CA 92111-3742

Mailing address

3760 Convoy St
204
San Diego, CA 92111
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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8378CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1164747416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST",
            "address_2": "204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92111",
            "telephone_number": "858-514-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST",
            "address_2": "204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113742",
            "telephone_number": "858-514-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "KRISTEN",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "8378",
            "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 1, 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.

Verify at the official NPI Registry.