Active NPI
Peter Benjamin Tharp
- Clinical Nurse Specialist
- San Diego, CA
National Provider Identifier
1194699744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 5238
- Practice address
- 923 Glendale Ave
San Diego, CA 92102-2723 - Phone
- (619) 312-7313
- NPI assigned
- Oct 6, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 5238 | CA | Primary |
Addresses
Primary practice location
923 Glendale Ave
San Diego, CA 92102-2723
Mailing address
923 Glendale Ave
San Diego, CA 92102-2723
Phone (619) 312-7313
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 |
|---|---|---|---|
| 5238 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1194699744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "923 GLENDALE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921022723",
"telephone_number": "619-312-7313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 GLENDALE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921022723",
"telephone_number": "619-312-7313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THARP",
"first_name": "PETER",
"middle_name": "BENJAMIN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-06",
"last_updated": "2025-10-06",
"certification_date": "2025-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "CA",
"license": "5238",
"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 Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.