Active NPI
Sarah Elise Bennett, OTR/L
- Skilled Nursing Facility
- Berkeley, CA
National Provider Identifier
1336469519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 5770
- Practice address
- 663 Colusa Ave
Berkeley, CA 94707-1517 - Phone
- (415) 717-2691
- NPI assigned
- Jun 10, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5770 | CA | |
| Skilled Nursing Facility | 314000000X | 5770 | CA | Primary |
Addresses
Primary practice location
663 Colusa Ave
Berkeley, CA 94707-1517
Mailing address
663 Colusa Avenue
Berkeley, CA 94707
Phone (415) 717-2691
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 |
|---|---|---|---|
| 5770 | CA | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1336469519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "663 COLUSA AVENUE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94707",
"telephone_number": "415-717-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "663 COLUSA AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947071517",
"telephone_number": "415-717-2691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "SARAH",
"middle_name": "ELISE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-10",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "5770",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "5770",
"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 Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.