Individual provider Active NPI

Pauline Nguyen, OTR/L

  • Occupational Therapist
  • Fremont, CA
National Provider Identifier
1649750696
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17528 Issued in CA
Practice address
39650 Liberty St
Fremont, CA 94538-2223
Phone
(510) 498-3900
NPI assigned
Aug 20, 2018
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT17528 CA Primary

Addresses

Primary practice location

39650 Liberty St
Fremont, CA 94538-2223

Mailing address

39650 Liberty St
Fremont, CA 94538-2223
Phone (510) 498-3900

Other practice location 1

5601 Norris Canyon Rd Ste 130
San Ramon, CA 94583-5407
Phone (866) 623-7600

Other practice location 2

4626 Willow Rd Ste 200
Pleasanton, CA 94588-8564
Phone (866) 623-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181016003208 CA Practitioner - Occupational Therapist in Private Practice 3678825833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT17528CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Mar 2, 2020 Accepting new patients
Tri-Valley Orthopedic and Sports Medical Group Inc Occupational Therapist Current Accepting new patients
Sutter Bay Medical Foundation Occupational Therapist CurrentSince Jun 12, 2022 Accepting new patients
Tri-Valley Orthopedic and Sports Medical Group Inc Occupational Therapist CurrentSince Aug 15, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Mar 2, 2020 Accepting new patients
Tri-Valley Orthopedic and Sports Medical Group Inc CurrentSince Aug 15, 2018 Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

39650 Liberty St
Fremont, CA 94538
Phone (510) 498-2689

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

4626 Willow Rd
Ste 200
Pleasanton, CA 94588
Phone (925) 463-0470

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

5601 Norris Canyon Rd
Ste 130
San Ramon, CA 94583
Phone (925) 463-0470

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

2180 W Grant Line Rd
Ste 100
Tracy, CA 95377
Phone (925) 463-0470

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Organizations & group practices 6

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1649750696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39650 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382223",
            "telephone_number": "510-498-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39650 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382223",
            "telephone_number": "510-498-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Norris Canyon Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945835407",
            "country_code": "US",
            "telephone_number": "866-623-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4626 Willow Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945888564",
            "country_code": "US",
            "telephone_number": "866-623-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAULINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT17528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.