Marla Overton Kelly, MOT, OTR

Individual provider Active NPI Occupational Therapist · Tiburon, CA

NPI 1215080239 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1215080239
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1066 (CA)
Practice address
1 Blackfield Dr
Tiburon, CA 94920-2053
Phone
(415) 383-6789
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1066CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Physical Therapy Past
since Aug 15, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1066 CA Yes
Pediatric Occupational Therapist 225XP0200X 1066 CA

Addresses

Primary practice location

1 Blackfield Dr
Tiburon, CA 94920-2053

Mailing address

44 Via San Fernando
Tiburon, CA 94920-2061
Phone (415) 789-5169

Other providers in Tiburon, CA

All providers in Tiburon, CA · Occupational Therapist in California

Sources for this page

Verify at the official NPI Registry.