Active NPI
Randal Scott Souza Sr.
- Occupational Therapist
- Chico, CA
National Provider Identifier
1629491303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4579
- Practice address
- 375 Cohasset Rd
Chico, CA 95926-2211 - Phone
- (530) 343-5595
- NPI assigned
- Jan 30, 2014
- Sex
- Male
- 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 | 4579 | CA | Primary |
Addresses
Primary practice location
375 Cohasset Rd
Chico, CA 95926-2211
Mailing address
4560 SE International Way Ste 100
Portland, OR 97222-4628
Phone (971) 206-5200
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 |
|---|---|---|---|
| 4579 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1629491303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972224628",
"telephone_number": "971-206-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 COHASSET RD",
"city": "CHICO",
"state": "CA",
"postal_code": "959262211",
"telephone_number": "530-343-5595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "RANDAL",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "4579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.