Jacqueline Butler

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

240169349 Issued in CA

Practice address

2092 Omega Rd Ste G
San Ramon, CA 94583-1230

Phone

(415) 637-7616

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Playdates. Soft Indoor Playlounge

  • Early Intervention Provider Agency
  • San Ramon, CA
  • NPI 1205642774

  Occupational Therapy Assistant

  NPD Authorized official

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1225481716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2092 OMEGA RD STE G",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831230",
            "telephone_number": "415-637-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2092 OMEGA RD STE G",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831230",
            "telephone_number": "415-637-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "3486",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "2413",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "CA",
            "license": "240169349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zerlene Burwell
• Lena Bustamante
• Andrew Butawan
• Eileen Hanson Butcher, PT
• Ralph Robert Butcher, MS, MFT
• C&F Medical Group Corp (Ramon Natural Medical Center)
• Karla Abigail Cabrera
• Cabulance Comfort, Inc. (Arcadia Ambulance)
• Ke'Aarre Cain, BCBA, IBA
• Angela Calcagno, MA, LMFT

• Early Intervention Provider Agency in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Early Intervention Provider Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.