Shakira Trizette Tietje, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

15271 Issued in CA

Practice address

545 Princeton PL
San Luis Obispo, CA 93405-1118

Phone

(805) 801-6003

NPI assigned

Sep 14, 2016

Last updated

Sep 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1225586522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PRINCETON PL",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051118",
            "telephone_number": "805-801-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 PRINCETON PL",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051118",
            "telephone_number": "805-801-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETJE",
        "first_name": "SHAKIRA",
        "middle_name": "TRIZETTE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "15271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tidelands Counseling
• Amy Valentine Tidik, MA,CCC-SP
• Julia Anne Tidik, PMHNP
• Stephen J Tidik, M.D.
• Elizabeth L Tienda
• Aiyana Tietze-Di Toro
• Vikram Raj Tiku, DDS
• Dena D Tilley, N.P.
• Wade Martin Tillotson, PT
• Mai Timberlake

• Occupational Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.