=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780265645
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALBERS THERAPY GROUP INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/21/2021
-----------------------------------------------------
Last Update Date | 10/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2364 ALTISMA WAY UNIT E
-----------------------------------------------------
City | CARLSBAD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92009-6320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-237-0167
-----------------------------------------------------
Fax | 760-881-8582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2364 ALTISMA WAY UNIT E
-----------------------------------------------------
City | CARLSBAD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92009-6320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-237-0167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | ASHLEY ALBERS
-----------------------------------------------------
Credential | MSOT R/L
-----------------------------------------------------
Telephone | 760-237-0167
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225XF0002X
-----------------------------------------------------
Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------