Individual provider Active NPI

Kristin De Guzman, OTR/L

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1457601213
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11971 Issued in CA
Practice address
3551 Roger Brooke Dr
McHe-QD (Creds)
San Antonio, TX 78234-4504
Phone
(210) 808-2231
NPI assigned
Sep 19, 2012
Last updated
Sep 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11971 CA
Occupational Therapist 225X00000X 11971 CA Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
McHe-QD (Creds)
San Antonio, TX 78234-4504

Mailing address

12330 Vance Jackson Road
Unit 6304
San Antonio, TX 78230
Phone (951) 741-3733

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

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1457601213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 VANCE JACKSON ROAD",
            "address_2": "UNIT 6304",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78230",
            "telephone_number": "951-741-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "MCHE-QD (CREDS)",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-808-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "KRISTIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "11971",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "11971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.