Active NPI
Alfreda Vasquez, PHYSICAL THERAPIST P
- Physical Therapist
- San Diego, CA
National Provider Identifier
1194977454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29079
- Practice address
- 4647 Zion Ave
San Diego, CA 92120 - Phone
- (619) 528-3912
- NPI assigned
- Oct 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 29079 | CA | |
| Physical Therapist | 225100000X | 29079 | CA | Primary |
Addresses
Primary practice location
4647 Zion Ave
San Diego, CA 92120
Mailing address
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3912
Other names 1
- Alfreda Hawkins
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29079 | CA | MD | Critical Care Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1194977454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4647 ZION AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92120",
"telephone_number": "619-528-3912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4647 ZION AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92120",
"telephone_number": "619-528-3912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "ALFREDA",
"credential": "PHYSICAL THERAPIST P",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-17",
"last_updated": "2024-11-07",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "29079",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "29079",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ALFREDA",
"last_name": "HAWKINS",
"credential": "PHYSICAL THERAPIST P",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.