Laura Moe, OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

14669 Issued in CA

Practice address

1630 Merrill St
Apt 509
Santa Cruz, CA 95062-4015

Phone

(503) 803-3375

NPI assigned

Sep 18, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wildflower Pediatric Therapy LLC

  • Pediatric Occupational Therapist
  • Yakima, WA
  • NPI 1063908382

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1275935413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N 34TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022220",
            "telephone_number": "503-803-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MERRILL ST",
            "address_2": "APT 509",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950624015",
            "telephone_number": "503-803-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "LAURA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60772125",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "14669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Mizelle, LMFT
• Daniel R Model, PSY
• Modesto Radiological Medical Group, Inc
• Catherine Pauline Modjeski, D.D.S
• Sapan Mody, MD
• Anny Leidy Mogollon
• Aly M Mohamed, MD
• Husna Mohammad
• Aron Jameson Mohan, MD
• Bryant Connor Mohan

• Pediatric Occupational Therapist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; 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.