Individual provider Active NPI

Geena Difatta, DPT

  • Physical Therapist
  • Daly City, CA
National Provider Identifier
1184016545
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42085 Issued in CA
Practice address
455 Hickey Blvd
Daly City, CA 94015-2629
Phone
(650) 746-3299
NPI assigned
Feb 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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 42085 CA Primary

Addresses

Primary practice location

455 Hickey Blvd
Daly City, CA 94015-2629

Mailing address

4611 Shasta LN
Paso Robles, CA 93446-4176
Phone (805) 296-1111

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
42085CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1184016545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 SHASTA LN",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934464176",
            "telephone_number": "805-296-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152629",
            "telephone_number": "650-746-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFATTA",
        "first_name": "GEENA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.