Mellisa Nicole Elrod, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

9626 Issued in CA

Practice address

1935 Gravenstein Hwy
Sebastopol, CA 95472

Phone

(707) 827-7675

NPI assigned

Aug 5, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1558916791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24",
            "city": "PENNGROVE",
            "state": "CA",
            "postal_code": "949510024",
            "telephone_number": "707-695-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 GRAVENSTEIN HWY",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "707-827-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELROD",
        "first_name": "MELLISA",
        "middle_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.