Individual provider Active NPI

Stephanie Helen Watts, GRAD DIP PHYS

  • Physical Therapist
  • Pleasanton, CA
National Provider Identifier
1760801419
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
41041 Issued in CA
Practice address
5980 Stoneridge Dr Ste 100
Pleasanton, CA 94588-2723
Phone
(925) 847-8833
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 41041 CA Primary
Orthopedic Physical Therapist 2251X0800X 41041 CA

Addresses

Primary practice location

5980 Stoneridge Dr Ste 100
Pleasanton, CA 94588-2723

Mailing address

506 Alden LN
Livermore, CA 94550-6349
Phone (925) 292-0304

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
Credentials
Diploma

State licenses

LicenseStateTypeSpecialty
41041CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1760801419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ALDEN LN",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945506349",
            "telephone_number": "925-292-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 STONERIDGE DR STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882723",
            "telephone_number": "925-847-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "STEPHANIE",
        "middle_name": "HELEN",
        "name_prefix": "Mrs.",
        "credential": "GRAD DIP PHYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41041",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "41041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.