Active NPI
Denise Harmon, COTA
- Occupational Therapy Assistant
- Lodi, CA
National Provider Identifier
1497411557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1067
- Practice address
- 1334 S Ham LN
Lodi, CA 95242-3903 - Phone
- (209) 334-3825
- NPI assigned
- Nov 12, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1067 | CA | Primary |
Addresses
Primary practice location
1334 S Ham LN
Lodi, CA 95242-3903
Mailing address
14113 Sargent Ave
Galt, CA 95632-8806
Phone (209) 224-1704
Other practice location 1
14113 Sargent Ave
Galt, CA 95632-8806
Phone (209) 224-1704
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 |
|---|---|---|---|
| 1067 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636675200000",
"number": "1497411557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14113 SARGENT AVE",
"city": "GALT",
"state": "CA",
"postal_code": "956328806",
"telephone_number": "209-224-1704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1334 S HAM LN",
"city": "LODI",
"state": "CA",
"postal_code": "952423903",
"telephone_number": "209-334-3825"
}
],
"practiceLocations": [
{
"address_1": "14113 Sargent Ave",
"address_purpose": "LOCATION",
"city": "Galt",
"state": "CA",
"postal_code": "956328806",
"country_code": "US",
"telephone_number": "209-224-1704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARMON",
"first_name": "DENISE",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-12",
"last_updated": "2021-11-12",
"certification_date": "2021-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "1067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.