NPIMap

Organization Active NPI

Pediatric Therapy Center

  • Pediatric Occupational Therapist
  • Aptos, CA
National Provider Identifier
1558488361
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT2656 Issued in CA
Legal business name
PEDIATRIC THERAPY CENTER
Practice address
1940 Bonita Dr. - Upstairs
Aptos, CA 95003
Phone
(831) 684-1804
Fax
(831) 684-1826
NPI assigned
Mar 25, 2007
Last updated
May 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Authorized official

Name
Keri Lynn Allen, MOT, OTR/L
Title
Director of Services- Owner
Phone
(831) 684-1804

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT29813 CA
Pediatric Occupational Therapist 225XP0200X OT2656 CA Primary
Pediatric Occupational Therapist 225XP0200X OT398 CA
Pediatric Occupational Therapist 225XP0200X OT6062 CA
Pediatric Occupational Therapist 225XP0200X OT7552 CA
Speech-Language Pathologist 235Z00000X SP11200 CA
Speech-Language Pathologist 235Z00000X SP12998 CA
Speech-Language Pathologist 235Z00000X SP5343 CA

Addresses

Primary practice location

1940 Bonita Dr. - Upstairs
Aptos, CA 95003

Mailing address

1940 Bonita Dr. - Upstairs
Aptos, CA 95003
Phone (831) 684-1804

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1940 Bonita Dr
Aptos, CA 95003
Phone (831) 684-1467

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1558488361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 BONITA DR. - UPSTAIRS",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "95003",
            "telephone_number": "831-684-1804",
            "fax_number": "831-684-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 BONITA DR. - UPSTAIRS",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "95003",
            "telephone_number": "831-684-1804",
            "fax_number": "831-684-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KERI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES- OWNER",
        "authorized_official_telephone_number": "831-684-1804",
        "authorized_official_credential": "MOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29813",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT2656",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT398",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT6062",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT7552",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP11200",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP12998",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP5343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aptos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.