Individual provider Active NPI

Denise Harmon, COTA

  • Occupational Therapy Assistant
  • Lodi, CA
National Provider Identifier
1497411557
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1067 Issued in CA
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

Updated by the provider on Nov 12, 2021

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 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

LicenseStateTypeSpecialty
1067CAMDOccupational 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.

Verify at the official NPI Registry.