Individual provider Active NPI

Debra Ann Kinkade

  • Occupational Therapy Assistant
  • Rancho Mirage, CA
National Provider Identifier
1437340494
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1539 Issued in CA
Practice address
72201 Country Club Dr
Rancho Mirage, CA 92270-4001
Phone
(790) 340-5999
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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 1539 CA Primary

Addresses

Primary practice location

72201 Country Club Dr
Rancho Mirage, CA 92270-4001

Mailing address

78487 Magenta Dr
La Quinta, CA 92253-6839

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
1539CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1437340494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78487 MAGENTA DR",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922536839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72201 COUNTRY CLUB DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704001",
            "telephone_number": "790-340-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKADE",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.