Individual provider Active NPI

Mary Kaster, M.S. OTR/L

  • Pediatric Occupational Therapist
  • Santa Rosa, CA
National Provider Identifier
1205074382
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT6236 Issued in CA
Practice address
2999 Cleveland Ave
Suite D
Santa Rosa, CA 95403-2761
Phone
(707) 546-9160
Fax
(707) 546-1338
NPI assigned
Jan 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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 OT6236 CA
Pediatric Occupational Therapist 225XP0200X OT6236 CA Primary

Addresses

Primary practice location

2999 Cleveland Ave
Suite D
Santa Rosa, CA 95403-2761

Mailing address

2999 Cleveland Ave
Suite D
Santa Rosa, CA 95403-2761
Phone (707) 546-9160

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT6236CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1205074382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 CLEVELAND AVE",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032761",
            "telephone_number": "707-546-9160",
            "fax_number": "707-546-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 CLEVELAND AVE",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032761",
            "telephone_number": "707-546-9160",
            "fax_number": "707-546-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTER",
        "first_name": "MARY",
        "credential": "M.S. OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT6236",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT6236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.