Individual provider Active NPI

Willow Dea, OT

  • Occupational Therapist
  • Mountain View, CA
National Provider Identifier
1245316983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTCA3473 Issued in CA
Practice address
2685 Marine Way
Suite 1411
Mountain View, CA 94040-1119
Phone
(650) 279-1084
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTCA3473 CA Primary

Addresses

Primary practice location

2685 Marine Way
Suite 1411
Mountain View, CA 94040-1119

Mailing address

1 Baywood Ave
7
San Mateo, CA 94402-1537
Phone (650) 344-6961

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

State licenses

LicenseStateTypeSpecialty
OTCA3473CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245316983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE",
            "address_2": "7",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021537",
            "telephone_number": "650-344-6961",
            "fax_number": "650-344-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 MARINE WAY",
            "address_2": "SUITE 1411",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401119",
            "telephone_number": "650-279-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEA",
        "first_name": "WILLOW",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OTCA3473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.