Individual provider Active NPI

Michelle Mambaje, MS, OTR/L

  • Occupational Therapist
  • Citrus Heights, CA
National Provider Identifier
1790278869
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13430 Issued in CA
Practice address
7777 Greenback LN Ste 110
Citrus Heights, CA 95610-5800
Phone
(916) 453-7944
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 13430 CA Primary

Addresses

Primary practice location

7777 Greenback LN Ste 110
Citrus Heights, CA 95610-5800

Mailing address

6792 Starboard Way
Sacramento, CA 95831-2414
Phone (916) 628-9490

Other practice location 1

855 Howe Ave
Sacramento, CA 95825-3912
Phone (844) 664-2248

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
13430CAMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health PastSince Jun 23, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1790278869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6792 STARBOARD WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958312414",
            "telephone_number": "916-628-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 GREENBACK LN STE 110",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956105800",
            "telephone_number": "916-453-7944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Howe Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958253912",
            "country_code": "US",
            "telephone_number": "844-664-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMBAJE",
        "first_name": "MICHELLE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.