Individual provider Active NPI

Lilyann Katherine Halbo, OTR/L

  • Pediatric Occupational Therapist
  • San Diego, CA
National Provider Identifier
1750025755
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
25601 Issued in CA
Practice address
11838 Bernardo Plaza CT Ste 110
San Diego, CA 92128-2414
Phone
(858) 673-5437
NPI assigned
Apr 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 25601 CA Primary

Addresses

Primary practice location

11838 Bernardo Plaza CT Ste 110
San Diego, CA 92128-2414

Mailing address

12427 Heatherton CT Apt 245
San Diego, CA 92128-5178

Other practice location 1

2445 Truxtun Rd Ste 205
San Diego, CA 92106-6154
Phone (619) 633-2119

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25601CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hardy and Lukes Physical Therapy, Inc. CurrentSince Oct 27, 2024 Accepting new patients
Callahan Associates Incorporated Pediatrics Past Accepting new patients
K.I.D.S. Therapy Associates, Inc., a Physical Therapy Corporation Pediatrics PastSince Oct 27, 2024 Accepting new patients

Locations

11838 Bernardo Plaza Ct
Ste 110
San Diego, CA 92128
Phone (858) 673-5434

41769 Enterprise Cir N
Ste 104107
Temecula, CA 92590

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1750025755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12427 HEATHERTON CT APT 245",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11838 BERNARDO PLAZA CT STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282414",
            "telephone_number": "858-673-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2445 Truxtun Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921066154",
            "country_code": "US",
            "telephone_number": "619-633-2119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALBO",
        "first_name": "LILYANN",
        "middle_name": "KATHERINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "25601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.