Debra Brodersen

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA1878 Issued in CA

Practice address

4560 SE International Way
Milwaukie, OR 97222-4628

Phone

(971) 206-5102

Fax

(971) 206-5211

NPI assigned

Jan 29, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rehab Specialists California, LLC

  • Physical Therapist
  • Los Altos, CA
  • NPI 1184668402
  NPD (past)

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1730502527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HERITAGE ROSE LN",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852743",
            "telephone_number": "707-422-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5102",
            "fax_number": "971-206-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERSEN",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA1878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Briley, RN
• Kathryn Marie Briney, COTAL
• Brenda J Brischetto, MD
• Karley Dona Brnusak, SPEECH LANGUAGE PATH
• Robyn Katrina Broad, PTA
• Heather Andrea Brooks
• Tiffany Christine Brooks, QMHA
• Sandra Lorraine Brookshaw, COTA
• Arlie Brown, RPH
• Claudia Brower Brown, OT

• Occupational Therapy Assistant in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Occupational Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.