Active NPI
Tracy Witty, OT
- Occupational Therapist
- Cathedral City, CA
National Provider Identifier
1760144000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17910
- Practice address
- 69472 Serenity Rd
Cathedral City, CA 92234-7921 - Phone
- (760) 409-6383
- Fax
- (855) 586-3292
- NPI assigned
- Oct 13, 2021
- Last updated
- Oct 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17910 | CA | Primary |
Addresses
Primary practice location
69472 Serenity Rd
Cathedral City, CA 92234-7921
Mailing address
69472 Serenity Rd
Cathedral City, CA 92234-7921
Phone (760) 409-6383
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 |
|---|---|---|---|
| 17910 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1760144000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69472 SERENITY RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922347921",
"telephone_number": "760-409-6383",
"fax_number": "855-586-3292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69472 SERENITY RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922347921",
"telephone_number": "760-409-6383",
"fax_number": "855-586-3292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTY",
"first_name": "TRACY",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-13",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "17910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.