Cecilia Fasanella Pennekamp, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

116910 Issued in TX

Practice address

10839 Quarry Park
San Antonio, TX 78233-4681

Phone

(102) 576-2602

Fax

(210) 451-8058

NPI assigned

Jul 28, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Cecilia Grace Fasanella Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1720463086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10839 QUARRY PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782334681",
            "telephone_number": "210-257-6260",
            "fax_number": "210-451-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10839 QUARRY PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782334681",
            "telephone_number": "102-576-2602",
            "fax_number": "210-451-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEKAMP",
        "first_name": "CECILIA",
        "middle_name": "FASANELLA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "1470",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILIA",
            "last_name": "FASANELLA",
            "middle_name": "GRACE",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ge Peng
• Jocelyn Samantha Penilla
• Jeri L Penkava, MD
• Kelsey Penn
• La'Shandria Penn, LCSW
• Janice Penner, MSW
• Sawyer Lee Penner
• Scott Penney, MD
• Elizabeth Pagan Pennington
• Keimya Pennington, IONM

• Occupational Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.