Active NPI
Katelyn Rose Gullatt, OTR
- Occupational Therapist
- Novato, CA
National Provider Identifier
1548829435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19142
- Practice address
- 1565 Hill Rd
Novato, CA 94947-4063 - Phone
- (415) 897-6161
- NPI assigned
- Jun 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 19142 | CA | Primary |
Addresses
Primary practice location
1565 Hill Rd
Novato, CA 94947-4063
Mailing address
606 Lion St
Ojai, CA 93023-2714
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19142 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1548829435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 LION ST",
"city": "OJAI",
"state": "CA",
"postal_code": "930232714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 HILL RD",
"city": "NOVATO",
"state": "CA",
"postal_code": "949474063",
"telephone_number": "415-897-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLATT",
"first_name": "KATELYN",
"middle_name": "ROSE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "19142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.