Active NPI
Krystle Wright
- Occupational Therapist
- Rancho Palos Verdes, CA
National Provider Identifier
1609314111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT11989
- Practice address
- 5801 Crestridge Rd
Rancho Palos Verdes, CA 90275-4961 - Phone
- (310) 265-5100
- NPI assigned
- Feb 3, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT11989 | CA | Primary |
Addresses
Primary practice location
5801 Crestridge Rd
Rancho Palos Verdes, CA 90275-4961
Mailing address
1301 E Bidwell St
Suie 201
Folsom, CA 95630-3565
Phone (916) 983-5915
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT11989 | Other | CA | CA DEPT OF CONSUMER AFFAIRS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT11989 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486080000000",
"number": "1609314111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 E BIDWELL ST",
"address_2": "SUIE 201",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956303565",
"telephone_number": "916-983-5915",
"fax_number": "916-983-5906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 CRESTRIDGE RD",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902754961",
"telephone_number": "310-265-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "KRYSTLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-03",
"last_updated": "2017-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT11989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA DEPT OF CONSUMER AFFAIRS",
"identifier": "OT11989",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Palos Verdes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.