Individual provider Active NPI

Ruth Fotouhi, OTR

  • Pediatric Occupational Therapist
  • Santa Rosa, CA
National Provider Identifier
1699167858
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 770 Issued in CA
Practice address
2665A Dutton MDW
Santa Rosa, CA 95407-7730
Phone
(707) 565-8188
NPI assigned
Feb 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT 770 CA Primary

Addresses

Primary practice location

2665A Dutton MDW
Santa Rosa, CA 95407-7730

Mailing address

2665A Dutton MDW
Santa Rosa, CA 95407-7730

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
OT 770CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1699167858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665A DUTTON MDW",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665A DUTTON MDW",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730",
            "telephone_number": "707-565-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTOUHI",
        "first_name": "RUTH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.