Active NPI
Brittany Nicole Diaz
- Occupational Therapist
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 009441
- Practice address
- 21045 N 9TH PL Ste 204
Phoenix, AZ 85024-5635 - Phone
- (602) 726-2300
- NPI assigned
- Sep 19, 2012
- Last updated
- May 28, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 117679 | TX | |
| Occupational Therapist | 225X00000X | 009441 | AZ | Primary |
| Speech-Language Pathologist | 235Z00000X | 37126 | TX |
Addresses
Primary practice location
21045 N 9TH PL Ste 204
Phoenix, AZ 85024-5635
Mailing address
2009 Mermaid Dr.
El Paso, TX 79936
Phone (915) 637-1676
Other practice location 1
10450 Brian Mooney Ave
El Paso, TX 79935-2809
Phone (915) 598-6616
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149984001 | Medicaid | TX | |
| 189296 | Medicaid | AZ | |
| 207164901 | Medicaid | TX |
Other names 1
- Brittany Alonzo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191125002797 | TX | Practitioner - Occupational Therapist in Private Practice | 4486087806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117679 | TX | MD | Social Worker |
| 009441 | AZ | MD | Occupational Therapist |
| 37126 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T3 Inc., LLC | Occupational Therapist | Current | Accepting new patients |
| Theraplay4Kidz, LLC | Occupational Therapist | Past | Accepting new patients |
Locations
14476 Horizon Blvd
#B1
Horizon City, TX 79928
Phone (915) 999-8746
14476 Horizon Blvd
Ste 2
Horizon City, TX 79928
Phone (915) 999-8746
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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": "1716854400000",
"number": "1518217355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2009 MERMAID DR.",
"city": "EL PASO",
"state": "TX",
"postal_code": "79936",
"telephone_number": "915-637-1676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21045 N 9TH PL STE 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850245635",
"telephone_number": "602-726-2300"
}
],
"practiceLocations": [
{
"address_1": "10450 Brian Mooney Ave",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799352809",
"country_code": "US",
"telephone_number": "915-598-6616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIAZ",
"first_name": "BRITTANY",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "117679",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "009441",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "37126",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149984001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189296",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207164901",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRITTANY",
"last_name": "ALONZO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.