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NPI Code Detail

MEDICARE: JOHN RYAN MSOT

MEDICARE: JOHN RYAN MSOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist16552
2225X00000XOccupational Therapist16552CA

General Provider Information

NPI Number : 1558295741
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN RYAN MSOT
Provider Business Mailing Address
First Line : 3871 PIEDMONT AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5378
Country : US
Telephone Number : 415-902-5544
Fax Number :
Provider Business Practice Location Address
First Line : 7140 GLADYS AVE
Second Line :
City : EL CERRITO
State : CA
Zip : 94530-2218
Country : US
Telephone Number : 415-902-5544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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