Denise Abansado Modolo, MOT/OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT2563 Issued in CA

Practice address

412 Redhill Ave
#1
San Anselmo, CA 94960

Phone

(415) 457-4409

Fax

(415) 488-9781

NPI assigned

Jan 21, 2009

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

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1922246479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTH KNOLL RD",
            "address_2": "#4",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-260-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 REDHILL AVE",
            "address_2": "#1",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "94960",
            "telephone_number": "415-457-4409",
            "fax_number": "415-488-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODOLO",
        "first_name": "DENISE",
        "middle_name": "ABANSADO",
        "name_prefix": "Mrs.",
        "credential": "MOT/OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT2563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren E Mendez, L.AC.
• Vera Renee Polintan Meyer, DMD
• Alina Gabriela Mihai
• Madrid Miller
• Gabrielle M. Miranda, M.S., MFT
• Sean Joseph Moloney, D.O.
• Ben Moltman, MFT-I
• Carlyn Marie Montes de Oca, LAC
• Jesse Morris, DC
• Stephanie Morris, PH.D.

• Pediatric Occupational Therapist in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.