Shannon Logan Sobieraj, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

13631 Issued in CA

Practice address

412 Red Hill Ave Ste 1
San Anselmo, CA 94960-2468

Phone

(415) 457-4409

NPI assigned

Jul 25, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1073955522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 TAMALPAIS RD",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301521",
            "telephone_number": "415-531-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 RED HILL AVE STE 1",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602468",
            "telephone_number": "415-457-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBIERAJ",
        "first_name": "SHANNON",
        "middle_name": "LOGAN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "13631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Sloat
• Alicia E Smart, PSYD
• Maggie Pesta Smida, OTR/L
• Ada Rosalyn Smith, MFT
• John Thomas Smith, D.D.S.
• Laura Soble, MFT
• Alexis Spalding
• Burrell Speights
• Christine Ann Spinda
• Ariel Marc Spindell, MFT

• Pediatric Occupational Therapist in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.