Active NPI
Noelle Bakken, OTR/L
- Pediatric Occupational Therapist
- Palo Alto, CA
National Provider Identifier
1609248459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 15600
- Practice address
- 725 Welch Rd
3Rd Floor
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8643
- NPI assigned
- Oct 20, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 15600 | CA | Primary |
Addresses
Primary practice location
725 Welch Rd
3Rd Floor
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
3Rd Floor
Palo Alto, CA 94304-1601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053305 | Medicaid | CA |
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 |
|---|---|---|---|
| 15600 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1609248459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"address_2": "3RD FLOOR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"address_2": "3RD FLOOR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKKEN",
"first_name": "NOELLE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "15600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "053305",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.