Carrie Marie Sullivan, MSOTR/L

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

OT5695 Issued in CA

Practice address

1356 University Ave
Berkeley, CA 94702-1711

Phone

(510) 845-5537

NPI assigned

Nov 18, 2010

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)

Not enrolled

State licenses

Practice roles

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.

• Neuro Wellness

  • Neurology Physical Therapist
  • Berkeley, CA
  • NPI 1730480633

  Neurorehabilitation

  NPD (past)

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1992007215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 COLLIER DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773817",
            "telephone_number": "510-483-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 UNIVERSITY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021711",
            "telephone_number": "510-845-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CARRIE",
        "middle_name": "MARIE",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CA",
            "license": "OT5695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Suazo, MA
• Julie Such
• Annemarie Sudermann, M.A.
• Alan Wesley Sue, DPM
• Jeffrey Allen Suiter, PSY.D.
• Gabriel Joseph Sullivan
• Joan Grant Sullivan, MD
• Stephanie M. Sullivan, MSN, NP
• Christine Tijen Sumbul
• Kayo Sumisaki, M.A., MFT

• Neurorehabilitation Occupational Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Neurorehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.