Individual provider Active NPI

Rachel Elizabeth Gunderson, COTA/L

  • Occupational Therapy Assistant
  • Danville, CA
National Provider Identifier
1053080929
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA3647 Issued in CA
Practice address
760 San Ramon Valley Blvd Ste 100
Danville, CA 94526-4057
Phone
(925) 743-8905
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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 OTA3647 CA Primary

Addresses

Primary practice location

760 San Ramon Valley Blvd Ste 100
Danville, CA 94526-4057

Mailing address

3956 Purdue Way
Livermore, CA 94550-3354
Phone (303) 886-4201

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
OTA3647CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Hand Rehabilitation Center CurrentSince Sep 23, 2021 Accepting new patients

Locations

760 San Ramon Valley Blvd
Ste 100
Danville, CA 94526
Phone (925) 743-8905

Organizations & group practices 1

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1053080929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3956 PURDUE WAY",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945503354",
            "telephone_number": "303-886-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 SAN RAMON VALLEY BLVD STE 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264057",
            "telephone_number": "925-743-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA3647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.