Carmela Grace Dizon, M.S. OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

24521 Issued in CA

Practice address

822 Antoinette LN Apt D
South San Francisco, CA 94080-3375

Phone

(650) 504-2413

NPI assigned

Oct 31, 2023

Last updated

Oct 31, 2023By the provider in NPPES

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

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1205609344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 ANTOINETTE LN APT D",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803375",
            "telephone_number": "650-504-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 ANTOINETTE LN APT D",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803375",
            "telephone_number": "650-504-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "CARMELA",
        "middle_name": "GRACE",
        "credential": "M.S. OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "24521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.