Individual provider Active NPI

Sophia Norah Delegard

  • Physical Therapist
  • Grass Valley, CA
National Provider Identifier
1699376269
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299326 Issued in CA
Practice address
715 Maltman Dr
Grass Valley, CA 95945-5184
Phone
(530) 272-7306
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299326 CA Primary

Addresses

Primary practice location

715 Maltman Dr
Grass Valley, CA 95945-5184

Mailing address

715 Maltman Dr
Grass Valley, CA 95945-5184
Phone (530) 272-7306

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

LicenseStateTypeSpecialty
299326CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1699376269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MALTMAN DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455184",
            "telephone_number": "530-272-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MALTMAN DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455184",
            "telephone_number": "530-272-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEGARD",
        "first_name": "SOPHIA",
        "middle_name": "NORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.