Active NPI
Kelli Meredith Clevette, OTR/L
- Hand Occupational Therapist
- Camarillo, CA
National Provider Identifier
1023494705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 12210
- Practice address
- 3901 Las Posas Rd Ste 8
Camarillo, CA 93010-1502 - Phone
- (805) 585-3706
- Fax
- (805) 384-1786
- NPI assigned
- Aug 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 00003746 | WA | |
| Hand Occupational Therapist | 225XH1200X | OT1059774 | OR | |
| Hand Occupational Therapist | 225XH1200X | 12210 | CA | Primary |
Addresses
Primary practice location
3901 Las Posas Rd Ste 8
Camarillo, CA 93010-1502
Mailing address
5720 Ralston St Ste 200
Ventura, CA 93003-7844
Phone (805) 804-4168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12210 | Other | CA | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://venturaortho.com/ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT1059774 | OR | MD | Hand Occupational Therapist |
| 00003746 | WA | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637971200000",
"number": "1023494705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 RALSTON ST STE 200",
"city": "VENTURA",
"state": "CA",
"postal_code": "930037844",
"telephone_number": "805-804-4168",
"fax_number": "805-830-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 LAS POSAS RD STE 8",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930101502",
"telephone_number": "805-585-3706",
"fax_number": "805-384-1786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVETTE",
"first_name": "KELLI",
"middle_name": "MEREDITH",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2021-11-27",
"certification_date": "2021-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "WA",
"license": "00003746",
"primary": false
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "OR",
"license": "OT1059774",
"primary": false
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "CA",
"license": "12210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "12210",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://venturaortho.com/",
"affiliation": "N",
"address_1": "3901 Las Posas Rd Ste 8",
"city": "Camarillo",
"state": "CA",
"country_code": "US",
"postal_code": "930101502",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.