Individual provider Active NPI

Maria Maribel Mazariego, COTA

  • Occupational Therapy Assistant
  • Fremont, CA
National Provider Identifier
1861960544
Registry record updated Nov 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA4586 Issued in CA
Practice address
2500 Country Dr
Fremont, CA 94536-5356
Phone
(510) 792-4242
NPI assigned
Nov 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA4586 CA Primary

Addresses

Primary practice location

2500 Country Dr
Fremont, CA 94536-5356

Mailing address

5583 Walnut Blossom Dr
San Jose, CA 95123-2281
Phone (862) 203-9649

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

LicenseStateTypeSpecialty
OTA4586CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541894400000",
    "number": "1861960544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5583 WALNUT BLOSSOM DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232281",
            "telephone_number": "862-203-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365356",
            "telephone_number": "510-792-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZARIEGO",
        "first_name": "MARIA",
        "middle_name": "MARIBEL",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-11",
        "last_updated": "2018-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA4586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2018; 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.