Active NPI
Andrea Coverdale, DPT
- Physical Therapist
- La Jolla, CA
National Provider Identifier
1750821906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 292207
- Practice address
- 9300 Campus Point Dr
La Jolla, CA 92037-1300 - Phone
- (855) 543-0333
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 292207 | CA | Primary |
Addresses
Primary practice location
9300 Campus Point Dr
La Jolla, CA 92037-1300
Mailing address
PO Box 232410
Apt 307
San Diego, CA 92193-2410
Phone (858) 249-6748
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
| License | State | Type | Specialty |
|---|---|---|---|
| 292207 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1750821906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"address_2": "APT 307",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410",
"telephone_number": "858-249-6748",
"fax_number": "619-543-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371300",
"telephone_number": "855-543-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COVERDALE",
"first_name": "ANDREA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-06",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "292207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.