M63 Inc.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

M63 INC.

Doing business as

Brainasium

Practice address

9085 Auburn Folsom Rd
Granite Bay, CA 95746-9656

Phone

(916) 780-1818

Fax

(916) 780-2112

NPI assigned

Sep 22, 2009

Last updated

Sep 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Moss

Title

President

Phone

(916) 780-1818

Specialties & licenses 1

Addresses

Other names 1

• Brainasium Doing business as

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1417281551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9085 AUBURN FOLSOM RD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957469656",
            "telephone_number": "916-780-1818",
            "fax_number": "916-780-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9085 AUBURN FOLSOM RD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957469656",
            "telephone_number": "916-780-1818",
            "fax_number": "916-780-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M63 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-780-1818",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brainasium",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ida Ruth Lundsten, CD(DONA)
• Derek Luu, PHARM.D.
• McKenna Kathleen Lyle
• Cecil O Lynch, MD
• Brittni Lynds
• Jonas Macomber
• Melvin V Macomber, PHD
• Johannah Macy
• Alexis Marisol Magana Camacho
• Reine Meagan De la Pena Magtibay

• Pediatric Occupational Therapist in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; 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.