Shayna De Kroon, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

14253 Issued in CA

Practice address

239 Eden Roc
Sausalito, CA 94965-3148

Phone

(530) 574-2595

NPI assigned

Sep 6, 2014

Last updated

Sep 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1972904274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 EDEN ROC",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949653148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 EDEN ROC",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949653148",
            "telephone_number": "530-574-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE KROON",
        "first_name": "SHAYNA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "14253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Sausalito, CA
• Providers in Sausalito, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2014; 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.