Active NPI
Marie-Noelle Poulin
- Occupational Therapist
- Ventura, CA
National Provider Identifier
1073823241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 2056
- Practice address
- 10730 Henderson Rd
Ventura, CA 93004-1832 - Phone
- (805) 647-1141
- Fax
- (805) 647-1148
- NPI assigned
- Oct 20, 2010
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 2056 | CA | Primary |
Addresses
Primary practice location
10730 Henderson Rd
Ventura, CA 93004-1832
Mailing address
10167 Jamestown St
Ventura, CA 93004-3755
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 |
|---|---|---|---|
| OT 2056 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287532800000",
"number": "1073823241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10167 JAMESTOWN ST",
"city": "VENTURA",
"state": "CA",
"postal_code": "930043755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10730 HENDERSON RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930041832",
"telephone_number": "805-647-1141",
"fax_number": "805-647-1148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULIN",
"first_name": "MARIE-NOELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-20",
"last_updated": "2010-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT 2056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.