Moira Sullivan, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3384 Issued in CA

Practice address

2066 Clarmar Way Ste a
San Jose, CA 95128-1715

Phone

(408) 280-7712

Fax

(408) 280-7721

NPI assigned

Dec 12, 2006

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

Credentials

Master of Science

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.

• Whole Kids Therapy Incorporated

  • Pediatric Occupational Therapist
  • San Jose, CA
  • NPI 1407379464
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124189394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 CLARMAR WAY STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281715",
            "telephone_number": "408-280-7712",
            "fax_number": "408-280-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 CLARMAR WAY STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281715",
            "telephone_number": "408-280-7712",
            "fax_number": "408-280-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MOIRA",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "3384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Sullivan, M.D.
• Leslie A Sullivan, M.D.
• Lisa Sullivan, M.A. LMFT
• Madelyn Sullivan
• Malin Sullivan
• Nora Sullivan
• Patti Sullivan, MFT
• Raymond Lawrence Sullivan Jr., MD
• Susan Ann Sullivan, M.S.
• John Matthew Sum, MD

• Occupational Therapist in San Jose, CA
• Providers in San Jose, 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 21, 2022; 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.