Active NPI
Shelby Wallach, OTR/L
- Occupational Therapist
- Corte Madera, CA
National Provider Identifier
1295325926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 22024
- Practice address
- 500 Tamal PLZ Ste 527
Corte Madera, CA 94925-1187 - Phone
- (415) 531-3027
- NPI assigned
- Jan 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 22024 | CA | Primary |
Addresses
Primary practice location
500 Tamal PLZ Ste 527
Corte Madera, CA 94925-1187
Mailing address
200 Bolinas Rd Apt 15
Fairfax, CA 94930-1938
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1295325926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 BOLINAS RD APT 15",
"city": "FAIRFAX",
"state": "CA",
"postal_code": "949301938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 TAMAL PLZ STE 527",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251187",
"telephone_number": "415-531-3027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACH",
"first_name": "SHELBY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-26",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "22024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.