Individual provider Active NPI

Carly Noelle Sanders, MOT, OTR/L

  • Pediatric Occupational Therapist
  • Pasadena, CA
National Provider Identifier
1093162208
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT16272 Issued in CA
Practice address
200 E del Mar Blvd
Suite 112
Pasadena, CA 91105-2544
Phone
(626) 564-2700
Fax
(626) 564-2770
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT16272 CA
Pediatric Occupational Therapist 225XP0200X OT16272 CA Primary

Addresses

Primary practice location

200 E del Mar Blvd
Suite 112
Pasadena, CA 91105-2544

Mailing address

200 E del Mar Blvd
Suite 112
Pasadena, CA 91105-2544
Phone (626) 564-2700

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
OT16272CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1093162208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD",
            "address_2": "SUITE 112",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052544",
            "telephone_number": "626-564-2700",
            "fax_number": "626-564-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD",
            "address_2": "SUITE 112",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052544",
            "telephone_number": "626-564-2700",
            "fax_number": "626-564-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CARLY",
        "middle_name": "NOELLE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16272",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT16272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.