Individual provider Active NPI

Marie Rebecca Hofmann, COTA/L

  • Occupational Therapy Assistant
  • Palm Desert, CA
National Provider Identifier
1376200485
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5537 Issued in CA
Practice address
75100 Mediterranean
Palm Desert, CA 92211-9069
Phone
(857) 325-4496
NPI assigned
Nov 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5537 CA Primary

Addresses

Primary practice location

75100 Mediterranean
Palm Desert, CA 92211-9069

Mailing address

1557 E San Jacinto Way
Palm Springs, CA 92262-5807
Phone (857) 325-4496

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

LicenseStateTypeSpecialty
5537CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Easy Speech Pathology, Inc. CurrentSince Nov 28, 2021 Accepting new patients

Locations

75100 Mediterranean
Palm Desert, CA 92211
Phone (760) 340-9832

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1376200485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 E SAN JACINTO WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625807",
            "telephone_number": "857-325-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75100 MEDITERRANEAN",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922119069",
            "telephone_number": "857-325-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFMANN",
        "first_name": "MARIE",
        "middle_name": "REBECCA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.

Verify at the official NPI Registry.