Active NPI
Betsy McCormick
- Mental Health Occupational Therapist
- Fairfield, CA
National Provider Identifier
1205167905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- 4664
- Practice address
- 101 Bodin Cir
Fairfield, CA 94535-1809 - Phone
- (707) 423-7899
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | 4664 | CA | Primary |
Addresses
Primary practice location
101 Bodin Cir
Fairfield, CA 94535-1809
Mailing address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone (707) 423-7899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4664 | Other | CA | OCCUPATIONAL THERAPIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1205167905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "BETSY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-19",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "CA",
"license": "4664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPIST",
"identifier": "4664",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.