Active NPI
Jill Davidson Mason, OTR
- Pediatric Occupational Therapist
- Roseville, CA
National Provider Identifier
1033445317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 10154
- Practice address
- 151 N Sunrise Ave Ste 1105
Roseville, CA 95661-2931 - Phone
- (916) 771-8255
- Fax
- (916) 771-8211
- NPI assigned
- Oct 21, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 10154 | CA | Primary |
Addresses
Primary practice location
151 N Sunrise Ave Ste 1105
Roseville, CA 95661-2931
Mailing address
151 N Sunrise Ave Ste 1105
Roseville, CA 95661-2931
Phone (916) 771-8255
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10154 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jabbergym, LLC | Pediatrics | Past | Accepting new patients |
| Jabbergym, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1033445317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 N SUNRISE AVE STE 1105",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956612931",
"telephone_number": "916-771-8255",
"fax_number": "916-771-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 N SUNRISE AVE STE 1105",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956612931",
"telephone_number": "916-771-8255",
"fax_number": "916-771-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "JILL",
"middle_name": "DAVIDSON",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-21",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "10154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.