Individual provider Active NPI

Kimberly Lynn Hatsumi Osheroff, PT

  • Physical Therapist
  • Novato, CA
National Provider Identifier
1881741254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20735 Issued in CA
Practice address
7200 Redwood Blvd
Suite 200
Novato, CA 94945
Phone
(415) 893-9285
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20735 CA Primary

Addresses

Primary practice location

7200 Redwood Blvd
Suite 200
Novato, CA 94945

Mailing address

484 Estado Way
Novato, CA 94945
Phone (415) 893-9285

Other names 1

  • Kimberly Lynn Hatsumi Maeda Former name

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
PT20735CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881741254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 ESTADO WAY",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94945",
            "telephone_number": "415-893-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 REDWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94945",
            "telephone_number": "415-893-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHEROFF",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN HATSUMI",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MAEDA",
            "middle_name": "LYNN HATSUMI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.