Active NPI
Tobias Wilson, OTR
- Occupational Therapist
- Antioch, CA
National Provider Identifier
1427792415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-2961
- Practice address
- 4441 Fawn Hill Way
Antioch, CA 94531-7123 - Phone
- (831) 332-7461
- NPI assigned
- Apr 25, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-198327 | AK | |
| Occupational Therapist | 225X00000X | OT-23618 | CA | |
| Occupational Therapist | 225X00000X | OT-2961 | NV | Primary |
Addresses
Primary practice location
4441 Fawn Hill Way
Antioch, CA 94531-7123
Mailing address
4441 Fawn Hill Way
Antioch, CA 94531-7123
Phone (831) 332-7461
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 |
|---|---|---|---|
| OT-198327 | AK | MD | Occupational Therapist |
| OT-23618 | CA | MD | Occupational Therapist |
| OT-2961 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1427792415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4441 FAWN HILL WAY",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945317123",
"telephone_number": "831-332-7461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4441 FAWN HILL WAY",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945317123",
"telephone_number": "831-332-7461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TOBIAS",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-25",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "OT-198327",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT-23618",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "OT-2961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.