Individual provider Active NPI

Nicolette Danielsen, OT

  • Occupational Therapist
  • Redding, CA
National Provider Identifier
1639413479
Registry record updated Nov 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7254 Issued in CA
Practice address
2516 Goodwater Ave Ste B
Redding, CA 96002-1559
Phone
(530) 242-1511
NPI assigned
Nov 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2012

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 7254 CA Primary

Addresses

Primary practice location

2516 Goodwater Ave Ste B
Redding, CA 96002-1559

Mailing address

2701 N Rocky Point Dr Ste 650
Tampa, FL 33607-5999
Phone (530) 242-1511

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

NPI Registry JSON

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

{
    "created_epoch": "1353110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353110400000",
    "number": "1639413479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N ROCKY POINT DR STE 650",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075999",
            "telephone_number": "530-242-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 GOODWATER AVE STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021559",
            "telephone_number": "530-242-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSEN",
        "first_name": "NICOLETTE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-17",
        "last_updated": "2012-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "7254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2012; 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.