Active NPI
Dawn Koren Stevenson, OTR/L
- Occupational Therapist
- Auburn, CA
National Provider Identifier
1093056640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13174
- Practice address
- 11985 Heritage Oak PL
Auburn, CA 95603-2413 - Phone
- (530) 889-0872
- NPI assigned
- Mar 6, 2013
- Last updated
- Mar 6, 2013
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13174 | CA | Primary |
| Occupational Therapist | 225X00000X | 6976 | MA | |
| Ergonomics Occupational Therapist | 225XE1200X | NU | ||
| Neurorehabilitation Occupational Therapist | 225XN1300X | NU | ||
| Mental Health Occupational Therapist | 225XM0800X | NU | ||
| Environmental Modification Occupational Therapist | 225XE0001X | NU | ||
| Low Vision Occupational Therapy Assistant | 224ZL0004X | NU |
Addresses
Primary practice location
11985 Heritage Oak PL
Auburn, CA 95603-2413
Mailing address
11327 Reid PL
Grass Valley, CA 95945-4300
Phone (530) 615-4228
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 |
|---|---|---|---|
| 6976 | MA | MD | Mental Health Counselor |
| 13174 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1093056640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11327 REID PL",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959454300",
"telephone_number": "530-615-4228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11985 HERITAGE OAK PL",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032413",
"telephone_number": "530-889-0872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "DAWN",
"middle_name": "KOREN",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "13174",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "6976",
"primary": false
},
{
"code": "225XE1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Ergonomics",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225XE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Environmental Modification",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "224ZL0004X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Low Vision",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.