Individual provider Active NPI

Cynthia Marie Rogers, COTA/L

  • Occupational Therapy Assistant
  • Pleasanton, CA
National Provider Identifier
1982179552
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA4589 Issued in CA
Practice address
2900 Stoneridge Dr
Pleasanton, CA 94588-8310
Phone
(925) 201-4050
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 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 OTA4589 CA Primary

Addresses

Primary practice location

2900 Stoneridge Dr
Pleasanton, CA 94588-8310

Mailing address

1768 W Stardust Dr
Taylorsville, UT 84129-1264
Phone (801) 577-4904

Other practice location 1

2900 Stoneridge Dr
Pleasanton, CA 94588-8310
Phone (925) 201-4050

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
OTA4589CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1982179552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 W STARDUST DR",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291264",
            "telephone_number": "801-577-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 STONERIDGE DR",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888310",
            "telephone_number": "925-201-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Stoneridge Dr",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945888310",
            "country_code": "US",
            "telephone_number": "925-201-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA4589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.