Individual provider Active NPI

Dylann Nicole Roch

  • Occupational Therapist
  • Santa Clara, CA
National Provider Identifier
1437998085
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
26557 Issued in CA
Practice address
410 N Winchester Blvd
Santa Clara, CA 95050-6325
Phone
(408) 248-3736
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 26557 CA Primary

Addresses

Primary practice location

410 N Winchester Blvd
Santa Clara, CA 95050-6325

Mailing address

655 S Willow St Ste 128
Manchester, NH 03103-5723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113001429 CA Practitioner - Occupational Therapist in Private Practice 2567990997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Physical Therapy CurrentSince Nov 7, 2024 Accepting new patients
MDRS Spine & Sport, Inc Occupational Therapist CurrentSince Nov 7, 2024 Accepting new patients
MDRS Spine & Sport, Inc Occupational Therapist CurrentSince Nov 7, 2024 Accepting new patients

Locations

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1437998085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST STE 128",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N WINCHESTER BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506325",
            "telephone_number": "408-248-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCH",
        "first_name": "DYLANN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "26557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.