Individual provider Active NPI

Renee H Nahum

  • Occupational Therapist
  • San Mateo, CA
National Provider Identifier
1538407531
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 12871 Issued in CA
Practice address
1650 S Amphlett Blvd
San Mateo, CA 94402-2517
Phone
(650) 638-9142
Fax
(650) 638-9141
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 12871 CA Primary
Pediatric Occupational Therapist 225XP0200X OT 12871 CA

Addresses

Primary practice location

1650 S Amphlett Blvd
San Mateo, CA 94402-2517

Mailing address

1650 S Amphlett Blvd
San Mateo, CA 94402-2517
Phone (650) 638-9142

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
OT 12871CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1538407531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S AMPHLETT BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022517",
            "telephone_number": "650-638-9142",
            "fax_number": "650-638-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S AMPHLETT BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022517",
            "telephone_number": "650-638-9142",
            "fax_number": "650-638-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAHUM",
        "first_name": "RENEE",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 12871",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 12871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.