Active NPI
Jean Ihle, OTR/L
- Occupational Therapist
- Mill Valley, CA
National Provider Identifier
1336754498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2317
- Practice address
- 49 Shell Rd
Mill Valley, CA 94941-1551 - Phone
- (415) 902-6132
- NPI assigned
- Sep 14, 2020
- 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 |
|---|---|---|---|---|
| Environmental Modification Occupational Therapist | 225XE0001X | 2317 | CA | |
| Occupational Therapist | 225X00000X | 2317 | CA | Primary |
Addresses
Primary practice location
49 Shell Rd
Mill Valley, CA 94941-1551
Mailing address
49 Shell Rd
Mill Valley, CA 94941-1551
Phone (415) 902-6132
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2317 | CA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1336754498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 SHELL RD",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949411551",
"telephone_number": "415-902-6132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 SHELL RD",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949411551",
"telephone_number": "415-902-6132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHLE",
"first_name": "JEAN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Environmental Modification",
"state": "CA",
"license": "2317",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "2317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.