Active NPI
Mark Bantugan Navasca, MS, OTR/L
- Occupational Therapist
- Walnut Creek, CA
National Provider Identifier
1205425683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12462
- Practice address
- 1975 Tice Valley Blvd
Walnut Creek, CA 94595-2201 - Phone
- (925) 906-0200
- NPI assigned
- Jan 11, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12462 | CA | Primary |
Addresses
Primary practice location
1975 Tice Valley Blvd
Walnut Creek, CA 94595-2201
Mailing address
1222 Nestwood Way
Milpitas, CA 95035-9004
Phone (510) 449-6425
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1205425683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 NESTWOOD WAY",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950359004",
"telephone_number": "510-449-6425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 TICE VALLEY BLVD",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945952201",
"telephone_number": "925-906-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVASCA",
"first_name": "MARK",
"middle_name": "BANTUGAN",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-11",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "12462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.