Individual provider Active NPI

Rebecca Miksic, OTR/L

  • Specialist
  • San Diego, CA
National Provider Identifier
1750533097
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT5603 Issued in CA
Practice address
10225 Barnes Canyon Rd
San Diego, CA 92121-2734
Phone
(619) 846-1196
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT5603 CA Primary

Addresses

Primary practice location

10225 Barnes Canyon Rd
San Diego, CA 92121-2734

Mailing address

9929 Maya Linda Rd Unit 3
San Diego, CA 92126-4141
Phone (619) 846-1196

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
OT5603CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1750533097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 MAYA LINDA RD UNIT 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264141",
            "telephone_number": "619-846-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 BARNES CANYON RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212734",
            "telephone_number": "619-846-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKSIC",
        "first_name": "REBECCA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OT5603",
            "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 Nov 6, 2013; 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.