Active NPI
Tiffany Osullivan
- Physical Therapist
- Martinez, CA
National Provider Identifier
1396499869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 35686
- Practice address
- 445 Blue Ridge Dr
Martinez, CA 94553-6005 - Phone
- (805) 714-4515
- NPI assigned
- Feb 3, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 35686 | CA | Primary |
Addresses
Primary practice location
445 Blue Ridge Dr
Martinez, CA 94553-6005
Mailing address
445 Blue Ridge Dr
Martinez, CA 94553-6005
Phone (805) 714-4515
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 |
|---|---|---|---|
| 35686 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1396499869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 BLUE RIDGE DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945536005",
"telephone_number": "805-714-4515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 BLUE RIDGE DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945536005",
"telephone_number": "805-714-4515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSULLIVAN",
"first_name": "TIFFANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-03",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "35686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.