Kaytlyn Ellida O'Connor, CMT, ROLFER

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

17671 Issued in CA

Practice address

5545 Claremont Ave
Oakland, CA 94618-1116

Phone

(510) 717-8649

NPI assigned

Jan 17, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1689204612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 BERKELEY WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947031505",
            "telephone_number": "510-717-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 CLAREMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181116",
            "telephone_number": "510-717-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KAYTLYN",
        "middle_name": "ELLIDA",
        "credential": "CMT, ROLFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "17671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "endpointDescription": "laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5545 Claremont Ave",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946181116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara O'Connell
• Vincent E O'Connell
• Moira K O'Connor Lenth, MD
• Ann M O'Connor, NP
• Erin Michelle O'Connor
• Jennifer Lori O'Daniel
• Kelcee Kathleen O'Daniel, ASW
• Betsy Encarnacion O'Donnell, M.D.
• Joanna White O'Donnell
• Katharine O'Donnell, MSW

• Massage Therapist in Oakland, CA
• Providers in Oakland, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.