Healthcare Provider Details

I. General information

NPI: 1063768786
Provider Name (Legal Business Name): EVA RESNICK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 GLADYS AVE
EL CERRITO CA
94530-2218
US

IV. Provider business mailing address

7140 GLADYS AVE
EL CERRITO CA
94530-2218
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-1545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number19497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: