Individual provider Active NPI

Diana Routkevich, COTA/L

  • Pediatric Occupational Therapist
  • Sacramento, CA
National Provider Identifier
1801360276
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTA4471 Issued in CA
Practice address
5270 Elvas Ave
Sacramento, CA 95819-2332
Phone
(916) 905-0902
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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 OTA4471 CA Primary

Addresses

Primary practice location

5270 Elvas Ave
Sacramento, CA 95819-2332

Mailing address

PO Box 277233
Sacramento, CA 95827-7233
Phone (916) 803-1489

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
OTA4471CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1801360276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277233",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958277233",
            "telephone_number": "916-803-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 ELVAS AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192332",
            "telephone_number": "916-905-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTKEVICH",
        "first_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OTA4471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.