Active NPI
Jessica Baskin, COTA/L
- Occupational Therapy Assistant
- Fremont, CA
National Provider Identifier
1306446562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4829
- Practice address
- 2500 Country Dr
Fremont, CA 94536-5356 - Phone
- (510) 792-4242
- NPI assigned
- Oct 27, 2020
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 4829 | CA | Primary |
Addresses
Primary practice location
2500 Country Dr
Fremont, CA 94536-5356
Mailing address
395 Ano Nuevo Ave Apt 604
Sunnyvale, CA 94085-1620
Phone (916) 402-7283
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 |
|---|---|---|---|
| 4829 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1306446562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 ANO NUEVO AVE APT 604",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940851620",
"telephone_number": "916-402-7283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 COUNTRY DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945365356",
"telephone_number": "510-792-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASKIN",
"first_name": "JESSICA",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "4829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.