Active NPI
Cody Lutz
- Gerontology Occupational Therapist
- Monterey, CA
National Provider Identifier
1811564180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 20247
- Practice address
- 23625 Holman Hwy
Monterey, CA 93940-5902 - Phone
- (831) 624-5311
- NPI assigned
- Jun 7, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 20247 | CA | Primary |
Addresses
Primary practice location
23625 Holman Hwy
Monterey, CA 93940-5902
Mailing address
704 Saddleback Cir
Livermore, CA 94551-0716
Phone (925) 339-6558
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | codylutz21@gmail.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20247 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1811564180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 SADDLEBACK CIR",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945510716",
"telephone_number": "925-339-6558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23625 HOLMAN HWY",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939405902",
"telephone_number": "831-624-5311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "CODY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-07",
"last_updated": "2021-06-07",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "CA",
"license": "20247",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "codylutz21@gmail.com",
"affiliation": "N",
"address_1": "23625 Holman Hwy",
"city": "Monterey",
"state": "CA",
"country_code": "US",
"postal_code": "939405902",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.