Donna Lynn Childs, O.T.R

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1013690 Issued in CA

Practice address

475 Memory LN
Boulder Creek, CA 95006-9130

Phone

(707) 445-8080

Fax

(707) 445-8088

NPI assigned

Feb 9, 2007

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Therapy in Your Home - OT, PT, St

  • Occupational Therapist
  • Los Gatos, CA
  • NPI 1558392423
  NPD
• Bellinger Chiropractic Corporation

  • Chiropractor
  • Eureka, CA
  • NPI 1376894766
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1114068434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 HARRISON AVE",
            "address_2": "SUITE D",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013234",
            "telephone_number": "707-445-8080",
            "fax_number": "707-445-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 MEMORY LN",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069130",
            "telephone_number": "707-445-8080",
            "fax_number": "707-445-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "O.T.R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "1013690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SS#",
            "identifier": "271 82 7541",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OT0053780",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTR LICENSE",
            "identifier": "1013690",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS' COMP",
            "identifier": "362098200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilfred Douglas Benoit, MFT
• Boulder Creek Pharmacy
• Brian James Britton, PHARMACIST
• Julie Anya Broder, LAC
• Patricia Brown, CCC-SLP
• Clary Sage Marriage and Family Therapy
• Dignity Health Medical Foundation
• Patricia Collins Dodge, PPS
• Joan Donato, LCSW
• Evare Psychology, a Professional Corporation

• Occupational Therapist in Boulder Creek, CA
• Providers in Boulder Creek, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.