Active NPI
Vanessa Ann Yackevicz, OTR/L, CPAM
- Occupational Therapist
- Walnut Creek, CA
National Provider Identifier
1689236572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17340
- Practice address
- 1449 Ygnacio Valley Rd
Walnut Creek, CA 94598-2932 - Phone
- (925) 939-5820
- NPI assigned
- Jul 1, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17340 | CA | Primary |
Addresses
Primary practice location
1449 Ygnacio Valley Rd
Walnut Creek, CA 94598-2932
Mailing address
161 N Civic Dr Apt 182
Walnut Creek, CA 94596-3905
Phone (214) 205-0091
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 |
|---|---|---|---|
| 17340 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1689236572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 N CIVIC DR APT 182",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945963905",
"telephone_number": "214-205-0091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1449 YGNACIO VALLEY RD",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982932",
"telephone_number": "925-939-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YACKEVICZ",
"first_name": "VANESSA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "OTR/L, CPAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-01",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "17340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.