Mimi Antonia Stroud Tinkelenberg, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

21151 Issued in CA

Practice address

855 Howe Ave
Sacramento, CA 95825-3912

Phone

(661) 619-1907

NPI assigned

Dec 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mimi Antonia Stroud Stroud Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1366258196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 I ST APT 1",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164570",
            "telephone_number": "661-619-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 HOWE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253912",
            "telephone_number": "661-619-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKELENBERG",
        "first_name": "MIMI",
        "middle_name": "ANTONIA STROUD",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "STROUD",
            "middle_name": "ANTONIA STROUD",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Berdejo Tindogan, NURSE PRACTITIONER
• Azaria Ting
• Lance Ray Tingle, LPCC CSAC
• Patricia Ronnica Tinglin, PMHNP-BC, FNP-BC
• Erica Nicole Tinjaca, MSW
• Jennifer Michelle Tinkle
• Cassandra Claire Tinkler
• Destiny Amber Tinney
• Vicki Chris Tinney
• Angelica Tinoco-Miranda

• Occupational Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.