Healthcare Provider Details

I. General information

NPI: 1023941937
Provider Name (Legal Business Name): DANIEL MULLANEY OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 PRINCE ST
BERKELEY CA
94703-2464
US

IV. Provider business mailing address

645 40TH ST
RICHMOND CA
94805-1809
US

V. Phone/Fax

Practice location:
  • Phone: 510-644-6313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number19787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: