Alexandra Maria Richardson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

144151 Issued in CA

Practice address

3835 Cypress Dr
Petaluma, CA 94954-6965

Phone

(707) 508-9485

NPI assigned

Nov 14, 2018

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

Other names 1

• Alexandra Rodriguez Vangelatos Former name

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": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1710456223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 SEQUOIA ST",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282833",
            "telephone_number": "707-508-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 CYPRESS DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546965",
            "telephone_number": "707-508-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "144151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "RODRIGUEZ VANGELATOS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lana Reuter, M.S.
• Joena Rosalia Revuelta Madrigal
• Maritza Reyes
• Tyler James Reynolds, IDHS
• Reza K. Aryanpour DDS, a Dental Corporation
• Kristin Joy Richman, CNM
• Naomi Bick Richman, MFT
• Craig Edmond Rickard, PHARMD
• Maria Ricks, M.ED
• Taylor Renee Ridenhour

• Occupational Therapist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.