Active NPI
Grace Kimberly Krueger, OT
- Occupational Therapist
- San Diego, CA
National Provider Identifier
1447930847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-2378
- Practice address
- 12400 High Bluff Dr
San Diego, CA 92130-3077 - Phone
- (720) 664-2216
- NPI assigned
- Jul 20, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 24134 | CA | |
| Occupational Therapist | 225X00000X | OT-2378 | HI | Primary |
Addresses
Primary practice location
12400 High Bluff Dr
San Diego, CA 92130-3077
Mailing address
12400 High Bluff Dr Ste 100
San Diego, CA 92130-3077
Phone (720) 664-2216
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-2378 | HI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1447930847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12400 HIGH BLUFF DR STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303077",
"telephone_number": "720-664-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12400 HIGH BLUFF DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303077",
"telephone_number": "720-664-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "GRACE",
"middle_name": "KIMBERLY",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-20",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "24134",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "OT-2378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.