Healthcare Provider Details

I. General information

NPI: 1760866354
Provider Name (Legal Business Name): KRISTTYN SUAREZ BEVERSTOCK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 KIRKER PASS RD
CLAYTON CA
94517-1096
US

IV. Provider business mailing address

5603 BETTENCOURT DR
CLAYTON CA
94517-1055
US

V. Phone/Fax

Practice location:
  • Phone: 925-567-5308
  • Fax:
Mailing address:
  • Phone: 925-250-3590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: