Individual provider Active NPI

Elyse Marissa Schenker, COTA/L

  • Occupational Therapy Assistant
  • Pleasanton, CA
National Provider Identifier
1780190025
Registry record updated Dec 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3944 Issued in CA
Practice address
300 Neal St
Pleasanton, CA 94566-7317
Phone
(925) 462-2400
NPI assigned
Dec 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3944 CA Primary

Addresses

Primary practice location

300 Neal St
Pleasanton, CA 94566-7317

Mailing address

12045 Cooperwood LN
Montgomery, OH 45242-6321
Phone (513) 532-7682

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
3944CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513900800000",
    "number": "1780190025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12045 COOPERWOOD LN",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452426321",
            "telephone_number": "513-532-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NEAL ST",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667317",
            "telephone_number": "925-462-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENKER",
        "first_name": "ELYSE",
        "middle_name": "MARISSA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-22",
        "last_updated": "2017-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "3944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; 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.