Individual provider Active NPI

Monica Avila Heitmann, O.T.L.

  • Occupational Therapist
  • San Rafael, CA
National Provider Identifier
1508914144
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9035 Issued in CA
Practice address
914 Mission Ave
San Rafael, CA 94901-6106
Phone
(415) 456-9350
Fax
(415) 456-1508
NPI assigned
Jan 8, 2007
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 9035 CA Primary

Addresses

Primary practice location

914 Mission Ave
San Rafael, CA 94901-6106

Mailing address

2925 Spring Creek Dr
Santa Rosa, CA 95405-7036
Phone (415) 608-2306

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
9035CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1508914144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SPRING CREEK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057036",
            "telephone_number": "415-608-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 MISSION AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949016106",
            "telephone_number": "415-456-9350",
            "fax_number": "415-456-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITMANN",
        "first_name": "MONICA",
        "middle_name": "AVILA",
        "name_prefix": "Ms.",
        "credential": "O.T.L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.