Michelle Erika Villavert Dytan, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

25336 Issued in CA

Practice address

1415 Ridgeback Rd Ste 21
Chula Vista, CA 91910-6984

Phone

(619) 207-0984

NPI assigned

Sep 20, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc.

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1326231713
  NPD
• Pediatric Therapy Works Speech-Language and Development Co

  • Speech-Language Pathologist
  • Chula Vista, CA
  • NPI 1124592563

  Occupational Therapist

  NPD
• Pediatric Therapy Works, Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Clearwater, FL
  • NPI 1730389248
  NPD (past)

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1508417544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 RIDGEBACK RD STE 21",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106984",
            "telephone_number": "619-207-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 RIDGEBACK RD STE 21",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106984",
            "telephone_number": "619-207-0984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1809 National Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921132113",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYTAN",
        "first_name": "MICHELLE ERIKA",
        "middle_name": "VILLAVERT",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "25336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dva Renal Healthcare Inc
• Kristen Dwyer, PH.D.
• Dymphna
• Dymphna San Diego TMS Inc
• Sean Dyson
• E L Racek MD Facs Inc
• Howard Glenn Eagle, D.D.S.
• Eagles Wings Home Care Inc.
• Trevor Michael Earl, PA-C
• Early Connections Therapy, Inc

• Occupational Therapist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.