Individual provider Active NPI

Sheri Marie Mortola, OTR/L, SWC

  • Pediatric Occupational Therapist
  • San Luis Obispo, CA
National Provider Identifier
1861787889
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
4531 Issued in CA
Practice address
776 Serrano Dr
San Luis Obispo, CA 93405-1754
Phone
(805) 440-6411
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X 4531 CA
Pediatric Occupational Therapist 225XP0200X 4531 CA Primary

Addresses

Primary practice location

776 Serrano Dr
San Luis Obispo, CA 93405-1754

Mailing address

776 Serrano Dr
San Luis Obispo, CA 93405-1754
Phone (805) 440-6411

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
4531CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1861787889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 SERRANO DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051754",
            "telephone_number": "805-440-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 SERRANO DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051754",
            "telephone_number": "805-440-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTOLA",
        "first_name": "SHERI",
        "middle_name": "MARIE",
        "credential": "OTR/L, SWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "CA",
            "license": "4531",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "4531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.