Susan Mary Lyneis-Sirias, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT5244 Issued in CA

Practice address

252 N. Main Street
Angels Camp, CA 95222-0278

Phone

(209) 736-9589

Fax

(209) 728-8938

NPI assigned

Jan 18, 2007

Last updated

Jan 11, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gold Country Occupational Therapy

  • Occupational Therapist
  • Angels Camp, CA
  • NPI 1649574807
  NPD (past) Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1306999099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SWEETWATER DR",
            "city": "MURPHYS",
            "state": "CA",
            "postal_code": "952479425",
            "telephone_number": "209-728-8938",
            "fax_number": "209-728-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 N. MAIN STREET",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220278",
            "telephone_number": "209-736-9589",
            "fax_number": "209-728-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNEIS-SIRIAS",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT5244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Lawrence
• Theresa Locke, P.T.
• Longs Drug Stores California LLC (CVS Pharmacy #09539)
• Everardo Lopez, M.D.
• Jane S Lucas, MFT
• M a C T Health Board, Incorporated (MACT Dental, Angels Camp)
• Lindell Krpan Maloney, PA-C
• Mark Twain Medical Center (Family Medical Center - Angels Camp)
• Mark Twain Union Elementary School District
• Gajan Tristan Mathivanan, PHARM.D

• Occupational Therapist in Angels Camp, CA
• Providers in Angels Camp, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.