Active NPI
Patricia Hazel Fasang, OTR/L
- Occupational Therapist
- San Diego, CA
National Provider Identifier
1225317530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11706
- Practice address
- 3737 6TH Ave.
Suite 103
San Diego, CA 92103 - Phone
- (619) 291-3515
- Fax
- (619) 291-3529
- NPI assigned
- Aug 4, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11706 | CA | Primary |
Addresses
Primary practice location
3737 6TH Ave.
Suite 103
San Diego, CA 92103
Mailing address
3737 6TH Ave.
Suite 103
San Diego, CA 92103
Phone (619) 291-3515
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 |
|---|---|---|---|
| 11706 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1225317530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3737 6TH AVE.",
"address_2": "SUITE 103",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-291-3515",
"fax_number": "619-291-3529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 6TH AVE.",
"address_2": "SUITE 103",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-291-3515",
"fax_number": "619-291-3529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASANG",
"first_name": "PATRICIA",
"middle_name": "HAZEL",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "11706",
"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 Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.