Individual provider Active NPI

Chelsea S Nicholas, PT

  • Physical Therapist
  • Oakland, CA
National Provider Identifier
1952942492
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297438 Issued in CA
Practice address
4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792
Phone
(510) 547-1630
Fax
(510) 923-1944
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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 297438 CA Primary

Addresses

Primary practice location

4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792

Mailing address

4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792
Phone (510) 547-1630

Other practice location 1

4341 Piedmont Ave Ste 103
Oakland, CA 94611-4766
Phone (510) 547-1630

Other identifiers 1

IdentifierTypeStateIssuer
297438OtherCASTATE OF CALIFORNIA BOARD OF PHYSICAL THERAPY

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

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1952942492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114792",
            "telephone_number": "510-547-1630",
            "fax_number": "510-923-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114792",
            "telephone_number": "510-547-1630",
            "fax_number": "510-923-1944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4341 Piedmont Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946114766",
            "country_code": "US",
            "telephone_number": "510-547-1630",
            "fax_number": "510-923-1944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "CHELSEA",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA BOARD OF PHYSICAL THERAPY",
            "identifier": "297438",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.