Active NPI
Dustine Lee
- Occupational Therapist
- Sacramento, CA
National Provider Identifier
1962187070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3072
- Practice address
- 4380 Auburn Blvd
Sacramento, CA 95841-4148 - Phone
- (916) 444-0033
- NPI assigned
- Jun 16, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3072 | CA | Primary |
Addresses
Primary practice location
4380 Auburn Blvd
Sacramento, CA 95841-4148
Mailing address
9355 E Stockton Blvd Ste 225
Elk Grove, CA 95624-9526
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jabbergym, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
4380 Auburn Blvd
Sacramento, CA 95841
Phone (916) 444-0033
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": "1686873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1962187070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9355 E STOCKTON BLVD STE 225",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956249526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4380 AUBURN BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958414148",
"telephone_number": "916-444-0033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DUSTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-16",
"last_updated": "2023-06-16",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "3072",
"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 Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.