Active NPI
Celine De Jesus, OTD, OTR/L
- Occupational Therapist
- Goodyear, AZ
National Provider Identifier
1336792373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-007874
- Practice address
- 13385 W McDowell Rd
Goodyear, AZ 85395-2631 - Phone
- (623) 986-5110
- NPI assigned
- Jul 18, 2019
- 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 | OTH-007874 | AZ | Primary |
Addresses
Primary practice location
13385 W McDowell Rd
Goodyear, AZ 85395-2631
Mailing address
2228 E Campbell Ave Apt 228
Phoenix, AZ 85016-5550
Phone (480) 689-0272
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 |
|---|---|---|---|
| OTH-007874 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1336792373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2228 E CAMPBELL AVE APT 228",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850165550",
"telephone_number": "480-689-0272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13385 W MCDOWELL RD",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853952631",
"telephone_number": "623-986-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "CELINE",
"credential": "OTD, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-007874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.