Individual provider Active NPI

Marineli Jovel Magno Duatin, OTD, OTR/L

  • Occupational Therapist
  • Marysville, CA
National Provider Identifier
1447855499
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
21902 Issued in CA
Practice address
726 4TH St
Marysville, CA 95901-5656
Phone
(530) 749-4300
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 21902 CA Primary

Addresses

Primary practice location

726 4TH St
Marysville, CA 95901-5656

Mailing address

726 4TH St
Marysville, CA 95901-5656

Other practice location 1

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

Other practice location 2

4001 Lone Tree Way
Antioch, CA 94509-6232
Phone (925) 754-0470

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

LicenseStateTypeSpecialty
21902CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1447855499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 4TH ST",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959015656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 4TH ST",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959015656",
            "telephone_number": "530-749-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "94954",
            "country_code": "US",
            "telephone_number": "707-763-4109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4001 Lone Tree Way",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945096232",
            "country_code": "US",
            "telephone_number": "925-754-0470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUATIN",
        "first_name": "MARINELI JOVEL",
        "middle_name": "MAGNO",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.