Individual provider Active NPI

Brooke Lafferty, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1548518483
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
14117 Issued in CA
Practice address
2385 Northside Dr Ste 200
San Diego, CA 92108-2702
Phone
(619) 757-2700
NPI assigned
Aug 27, 2012
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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 15333 FL
Occupational Therapist 225X00000X 14117 CA Primary

Addresses

Primary practice location

2385 Northside Dr Ste 200
San Diego, CA 92108-2702

Mailing address

2859 Eagle St
San Diego, CA 92103-5421
Phone (772) 834-4624

Other practice location 1

6414 13th Rd S
Greenacres, FL 33415-1401
Phone (561) 640-3056

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 15333FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1548518483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 EAGLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035421",
            "telephone_number": "772-834-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 NORTHSIDE DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082702",
            "telephone_number": "619-757-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6414 13th Rd S",
            "address_purpose": "LOCATION",
            "city": "Greenacres",
            "state": "FL",
            "postal_code": "334151401",
            "country_code": "US",
            "telephone_number": "561-640-3056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "BROOKE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 15333",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "14117",
            "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 Mar 2, 2020; 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.