Individual provider Active NPI

Erica Kanna Namba, D.P.T

  • Physical Therapist
  • San Carlos, CA
National Provider Identifier
1174055875
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292837 Issued in CA
Practice address
125 Shoreway Rd
Suite a
San Carlos, CA 94070-2788
Phone
(650) 556-9420
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 292837 CA Primary

Addresses

Primary practice location

125 Shoreway Rd
Suite a
San Carlos, CA 94070-2788

Mailing address

3348 La Mesa Dr
#2
San Carlos, CA 94070-4205
Phone (225) 802-4040

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
292837CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1174055875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3348 LA MESA DR",
            "address_2": "#2",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940704205",
            "telephone_number": "225-802-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SHOREWAY RD",
            "address_2": "SUITE A",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702788",
            "telephone_number": "650-556-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBA",
        "first_name": "ERICA",
        "middle_name": "KANNA",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.