Active NPI
Pamela Kaye Baraceros
- Occupational Therapist
- Los Gatos, CA
National Provider Identifier
1194400168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 24398
- Practice address
- 355 Dardanelli LN.
Los Gatos, CA 95032 - Phone
- (408) 726-2339
- NPI assigned
- Jun 19, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 24398 | CA | Primary |
Addresses
Primary practice location
355 Dardanelli LN.
Los Gatos, CA 95032
Mailing address
3112 Zion LN
San Jose, CA 95132-2362
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 |
|---|---|---|---|
| 24398 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1194400168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3112 ZION LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951322362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 DARDANELLI LN.",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "95032",
"telephone_number": "408-726-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARACEROS",
"first_name": "PAMELA",
"middle_name": "KAYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2023-06-30",
"certification_date": "2023-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "24398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.