Individual provider Active NPI

Krista Kellenberger, OT

  • Occupational Therapist
  • Oceanside, CA
National Provider Identifier
1376785188
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3348 Issued in CA
Practice address
1674 Mustang Way
Oceanside, CA 92057-5611
Phone
(760) 579-2266
NPI assigned
Mar 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3348 CA
Occupational Therapist 225X00000X OT3348 CA Primary

Addresses

Primary practice location

1674 Mustang Way
Oceanside, CA 92057-5611

Mailing address

1674 Mustang Way
Oceanside, CA 92057-5611
Phone (760) 579-2266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000786 CA Practitioner - Occupational Therapist in Private Practice 8426078841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Physical Therapy Providers and Wellness IncGroup PAC ID 4789989955, 12 clinicians

Practice addresses (Care Compare)

403 W 5TH Ave
Suite C
Escondido, CA 92025-4851
Phone (760) 536-2377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Home Physical Therapy Providers & Wellness Inc. CurrentSince May 1, 2025 Accepting new patients
Active Life Rehab, Inc. Past Accepting new patients
In-Home Physical Therapy PC PastSince Nov 1, 2019 Accepting new patients

Locations

403 W 5th Ave
Ste C
Escondido, CA 92025
Phone (760) 536-2377

1611 S Melrose Dr
#311
Vista, CA 92081

1611 S Melrose Dr
Ste A
Vista, CA 92081
Phone (760) 230-3451

Organizations & group practices 3

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": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1376785188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 MUSTANG WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575611",
            "telephone_number": "760-579-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 MUSTANG WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575611",
            "telephone_number": "760-579-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLENBERGER",
        "first_name": "KRISTA",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-26",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "3348",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT3348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.