Individual provider Active NPI

Charles Dominick Trentacosti, COTA, RRT

  • Environmental Modification Occupational Therapy Assistant
  • Visalia, CA
National Provider Identifier
1932585700
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X
License
3064 Issued in CA
Practice address
514 N Bridge St
Visalia, CA 93291
Phone
(559) 732-8614
NPI assigned
Aug 4, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapy Assistant 224ZE0001X 3064 CA Primary
Environmental Modification Occupational Therapy Assistant 224ZE0001X OP008057 PA
Environmental Modification Occupational Therapy Assistant 224ZE0001X OTA0000002476 TN

Addresses

Primary practice location

514 N Bridge St
Visalia, CA 93291

Mailing address

3222 Oak Borough Run
Fort Wayne, IN 46804

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
OP008057PAMDEnvironmental Modification Occupational Therapy Assistant
OTA0000002476TNMDEnvironmental Modification Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1932585700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 OAK BOROUGH RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 N BRIDGE ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "559-732-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTACOSTI",
        "first_name": "CHARLES",
        "middle_name": "DOMINICK",
        "name_prefix": "Mr.",
        "credential": "COTA, RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "CA",
            "license": "3064",
            "primary": true
        },
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "PA",
            "license": "OP008057",
            "primary": false
        },
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "TN",
            "license": "OTA0000002476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.