Healthcare Provider Details

I. General information

NPI: 1558295741
Provider Name (Legal Business Name): JOHN RYAN MSOT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 GLADYS AVE
EL CERRITO CA
94530-2218
US

IV. Provider business mailing address

3871 PIEDMONT AVE
OAKLAND CA
94611-5378
US

V. Phone/Fax

Practice location:
  • Phone: 415-902-5544
  • Fax:
Mailing address:
  • Phone: 415-902-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number16552
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number16552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: