STELLA MOON (NPI# 1578184628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578184628 |
| Entity Type | Individual |
| Full Name | STELLA MOON |
| Practice Address |
320 Tesconi Cir Ste G Santa Rosa CA 95401-4611 |
| Practice Telephone | 7075442637 |
| Practice Fax Number | 7075442088 |
| Mailing Telephone | 7075442637 |
| Mailing Fax Number | 7075442088 |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | OTA2154 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
320 TESCONI CIR STE G |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629587068 | Rachel Elizabeth King | Occupational Therapist | 320 Tesconi Cir Ste G, Santa Rosa, CA 95401-4611 | 2017-09-28 |
| 1821628991 | Physiotherapy Associates, Inc. | Durable Medical Equipment & Medical Supplies | 320 Tesconi Cir Ste G, Santa Rosa, CA 95401-4611 | 2020-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700137767 | Maya Barrett | Occupational Therapy Assistant | 4655 Quigg Dr Apt 833, Santa Rosa, CA 95409-5394 | 2012-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089304 | Buenaventura Peralta | Occupational Therapy Assistant | 139 N Walnut Ave, Placentia, CA 92870-5643 | 2020-10-07 |
| 1578170619 | Noe Ramirez Lopez | Occupational Therapy Assistant | 650 Marvin Way, Dixon, CA 95620-3342 | 2020-09-23 |
| 1790391415 | Michael Vidal | Occupational Therapy Assistant | 2126 Oregon Ave, Long Beach, CA 90806-4141 | 2020-09-17 |
| 1386259273 | Rachel Le | Occupational Therapy Assistant | 11909 Elmcroft Ave, Norwalk, CA 90650-7730 | 2020-09-09 |
| 1790399913 | Alexander Toussaint | Occupational Therapy Assistant | 3731 E Harding St, Long Beach, CA 90805-3934 | 2020-09-04 |
| 1710590757 | Lisa M Smith | Occupational Therapy Assistant | 920 Westacre Rd, West Sacramento, CA 95691-3224 | 2020-08-28 |
| 1083226419 | Olivia Clark | Occupational Therapy Assistant | 2905 Bearcreek Ct, Fullerton, CA 92835-3143 | 2020-08-18 |
| 1174133961 | Pacasie Kamikazi | Occupational Therapy Assistant | 8501 Bruceville Rd, Elk Grove, CA 95758-7258 | 2020-08-06 |
| 1093323297 | Catherine Hsi | Occupational Therapy Assistant | 1241 Ashby Ave, Berkeley, CA 94702-2401 | 2020-07-14 |
| 1790302453 | Elnura Kim | Occupational Therapy Assistant | 13665 Newcastle Ct, Fontana, CA 92335-0588 | 2020-06-29 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.