Active NPI
T'Kara Lynees McKinney, COTA/L
- Occupational Therapy Assistant
- San Clemente, CA
National Provider Identifier
1821547779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3508
- Practice address
- 1120 Via Callejon
Ste B
San Clemente, CA 92673-6213 - Phone
- (949) 498-5100
- Fax
- (949) 366-5665
- NPI assigned
- Oct 3, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3508 | CA | Primary |
| Nurse's Aide | 376K00000X | 00830163 | CA |
Addresses
Primary practice location
1120 Via Callejon
Ste B
San Clemente, CA 92673-6213
Mailing address
1120 Via Callejon, Ste B
San Clemente, CA 92673
Phone (949) 498-5100
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 |
|---|---|---|---|
| 00830163 | CA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1821547779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 VIA CALLEJON, STE B",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "92673",
"telephone_number": "949-498-5100",
"fax_number": "949-366-5665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 VIA CALLEJON",
"address_2": "STE B",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926736213",
"telephone_number": "949-498-5100",
"fax_number": "949-366-5665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "T'KARA",
"middle_name": "LYNEES",
"name_prefix": "Miss",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-03",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "3508",
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "CA",
"license": "00830163",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Clemente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.