Tristan Jayson Retuya, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT12378 Issued in CA

Practice address

4275 Executive Square #200
La Jolla, CA 92037-1511

Phone

(858) 414-8174

NPI assigned

Jul 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Encore Home Therapy Inc.

  • Occupational Therapist
  • Escondido, CA
  • NPI 1417721754
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1699039834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "800-944-9782",
            "fax_number": "610-438-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 EXECUTIVE SQUARE #200",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371511",
            "telephone_number": "858-414-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETUYA",
        "first_name": "TRISTAN",
        "middle_name": "JAYSON",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT12378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Resnick
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• Caitlin Reyes, PHARMD
• Denise Reyes, R.D.
• Gabriel Reyes
• Shaila Simbulan Reyes

• Occupational Therapist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.