Active NPI
Maria Tan
- Mental Health Occupational Therapist
- Redwood City, CA
National Provider Identifier
1609997436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- OT842
- Practice address
- 727 Shasta St
Redwood City, CA 94063-2124 - Phone
- (650) 573-3619
- NPI assigned
- Apr 2, 2007
- Last updated
- Jul 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | |||
| Mental Health Occupational Therapist | 225XM0800X | OT842 | CA | Primary |
Addresses
Primary practice location
727 Shasta St
Redwood City, CA 94063-2124
Mailing address
727 Shasta St
Redwood City, CA 94063-2124
Phone (650) 573-3619
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT842 | CA | MD | Mental Health Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Mateo | Past | Accepting new patients |
Organizations & group practices 1
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": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1609997436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 SHASTA ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940632124",
"telephone_number": "650-573-3619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 SHASTA ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940632124",
"telephone_number": "650-573-3619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "CA",
"license": "OT842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.