Individual provider Active NPI

Stacy Frauwirth, OTR/L

  • Occupational Therapist
  • Berkeley, CA
National Provider Identifier
1649606732
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT5312 Issued in CA
Practice address
3075 Adeline St Ste 120
Berkeley, CA 94703
Phone
(510) 225-7519
NPI assigned
Sep 19, 2013
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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 OT5312 CA Primary

Addresses

Primary practice location

3075 Adeline St Ste 120
Berkeley, CA 94703

Mailing address

3075 Adeline St Ste 120
Berkeley, CA 94703-2579
Phone (510) 225-7519

Other practice location 1

458 Marina Way
Richmond, CA 94801-3231
Phone (925) 864-0727

Other practice location 2

458 Marina Way
Richmond, CA 94801-3231
Phone (925) 864-0727

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

LicenseStateTypeSpecialty
OT5312CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1649606732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 ADELINE ST STE 120",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032579",
            "telephone_number": "510-225-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 ADELINE ST STE 120",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94703",
            "telephone_number": "510-225-7519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "458 Marina Way",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948013231",
            "country_code": "US",
            "telephone_number": "925-864-0727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "458 Marina Way",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948013231",
            "country_code": "US",
            "telephone_number": "925-864-0727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAUWIRTH",
        "first_name": "STACY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT5312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.