Individual provider Active NPI

Katherine Callaghan, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1902664220
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
25691 Issued in CA
Practice address
9825 Glen Center Dr
San Diego, CA 92131-1689
Phone
(858) 293-3900
NPI assigned
Mar 11, 2024
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 25691 CA Primary

Addresses

Primary practice location

9825 Glen Center Dr
San Diego, CA 92131-1689

Mailing address

4150 Vermont St
San Diego, CA 92103-2356
Phone (619) 316-2359

Other practice location 1

4075 54th St
San Diego, CA 92105-2301
Phone (619) 582-5168

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
25691CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC Occupational Therapist CurrentSince Feb 19, 2024 Accepting new patients
Crestview HC LLC CurrentSince Mar 17, 2024 Accepting new patients

Locations

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

9825 Glen Center Dr
San Diego, CA 92131
Phone (858) 293-3900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1902664220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 VERMONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032356",
            "telephone_number": "619-316-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 GLEN CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311689",
            "telephone_number": "858-293-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4075 54th St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921052301",
            "country_code": "US",
            "telephone_number": "619-582-5168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAGHAN",
        "first_name": "KATHERINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "25691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.