Individual provider Active NPI

Amanda Jean Beck, MS OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1194956714
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 10584 Issued in CA
Practice address
11665 Avena PL
Suite 106
San Diego, CA 92128-2421
Phone
(858) 673-5437
Fax
(858) 673-5434
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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 OT 10584 CA Primary

Addresses

Primary practice location

11665 Avena PL
Suite 106
San Diego, CA 92128-2421

Mailing address

1250 Downing St
Imperial Beach, CA 91932-3322

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT 10584CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1194956714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 DOWNING ST",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 AVENA PL",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282421",
            "telephone_number": "858-673-5437",
            "fax_number": "858-673-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 10584",
            "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 30, 2009; 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.