Jessica Thibeault

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

16670 Issued in CA

Practice address

4179 Piedmont Ave
#201
Oakland, CA 94611-5186

Phone

(510) 333-4579

NPI assigned

Dec 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Baby Builders, Inc

  • Developmental Disabilities Clinic/Center
  • Oakland, CA
  • NPI 1619390473
  NPD (past)

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1174066575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4179 PIEDMONT AVE",
            "address_2": "#201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115186",
            "telephone_number": "510-333-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4179 PIEDMONT AVE",
            "address_2": "#201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115186",
            "telephone_number": "510-333-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "16670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "OT16670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Thein
• Suleiman J. Theodossy, MD
• Thera Share Counseling and Consulting Inc (Thera Share)
• Therapeutic Solutions for Families, Licensed Clinical Social Worker Inc.
• Keith M. Thibault, NP
• Brent Thibeaux
• Mark Raymond Thibedeau, ACSW
• Tasha Thibodeaux
• Zoe Thiele-Seidenberg
• Thien Lake Acupuncture

• Pediatric Occupational Therapist in Oakland, CA
• Providers in Oakland, 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 Dec 2, 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.