Individual provider Active NPI

Maren Clausen, PTA

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1497126254
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3975 Issued in CA
Practice address
4858 Lila Dr
San Diego, CA 92115-1910
Phone
(619) 540-0502
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3975 CA Primary

Addresses

Primary practice location

4858 Lila Dr
San Diego, CA 92115-1910

Mailing address

4858 Lila Dr
San Diego, CA 92115-1910
Phone (619) 540-0502

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": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1497126254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4858 LILA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151910",
            "telephone_number": "619-540-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4858 LILA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151910",
            "telephone_number": "619-540-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSEN",
        "first_name": "MAREN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "3975",
            "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 Oct 19, 2015; 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.