Wendy April Phillips, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

4210 Issued in CA

Practice address

18 Commercial Blvd Ste 6
Novato, CA 94949-6120

Phone

(415) 320-1329

Fax

(415) 729-1780

NPI assigned

Nov 29, 2024

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

Other names 1

• Wendy April De Forest Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Starburst Therapy Inc

  • Pediatric Occupational Therapist
  • Novato, CA
  • NPI 1144946310

  Pediatrics

  NPD

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1609692110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 W BALTIMORE AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949392126",
            "telephone_number": "415-342-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 COMMERCIAL BLVD STE 6",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496120",
            "telephone_number": "415-320-1329",
            "fax_number": "415-729-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "WENDY",
        "middle_name": "APRIL",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "4210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "DE FOREST",
            "middle_name": "APRIL",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Trisha Renee Petticrew, PHARMD
• Theodore Thien Phan
• Jean-Pierre Phancao, M.D.
• Pharmaca Integrative Pharmacy, Inc.
• Walter H. Phillips, MFT
• Sorbarikor Piawah, M.D.
• Paula Piccirilli
• Jane Ellen Piel, CCC/SLP
• Donald A. Pierce, MD
• Nathalia Pierson Brom Vieira

• Pediatric Occupational Therapist in Novato, CA
• Providers in Novato, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.