Active NPI
Mikaela Olivia Dunn, PT, DPT
- Physical Therapist
- Berkeley, CA
National Provider Identifier
1275042178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040.0129073
- Practice address
- 1888 Ashby Ave Apt 2
Berkeley, CA 94703-2220 - Phone
- (802) 793-9529
- NPI assigned
- Sep 22, 2017
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040.0129073 | VT | Primary |
Addresses
Primary practice location
1888 Ashby Ave Apt 2
Berkeley, CA 94703-2220
Mailing address
1888 Ashby Ave Apt 2
Berkeley, CA 94703-2220
Phone (802) 793-9529
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040.0129073 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1275042178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1888 ASHBY AVE APT 2",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032220",
"telephone_number": "802-793-9529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1888 ASHBY AVE APT 2",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032220",
"telephone_number": "802-793-9529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "MIKAELA",
"middle_name": "OLIVIA",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040.0129073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.