Active NPI
Sandra Gail Rutstein, OTR,L
- Pediatric Occupational Therapist
- Grover Beach, CA
National Provider Identifier
1922295401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT4777
- Practice address
- 191 S Oak Park Blvd Ste 9
Grover Beach, CA 93433-2265 - Phone
- (805) 474-6811
- Fax
- (805) 668-2290
- NPI assigned
- Sep 28, 2007
- Last updated
- Feb 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT4777 | CA | Primary |
Addresses
Primary practice location
191 S Oak Park Blvd Ste 9
Grover Beach, CA 93433-2265
Mailing address
191 S Oak Park Blvd Ste 9
Grover Beach, CA 93433-2265
Phone (805) 474-6811
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT4777 | CA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Directions for Kids | Pediatrics | Current | Accepting new patients |
Locations
191 S Oak Park Blvd
Ste 9
Grover Beach, CA 93433
Phone (805) 474-6811
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1922295401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 S OAK PARK BLVD STE 9",
"city": "GROVER BEACH",
"state": "CA",
"postal_code": "934332265",
"telephone_number": "805-474-6811",
"fax_number": "805-668-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 S OAK PARK BLVD STE 9",
"city": "GROVER BEACH",
"state": "CA",
"postal_code": "934332265",
"telephone_number": "805-474-6811",
"fax_number": "805-668-2290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTSTEIN",
"first_name": "SANDRA",
"middle_name": "GAIL",
"name_prefix": "Miss",
"credential": "OTR,L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-28",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "OT4777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grover Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.