Healthcare Provider Details

I. General information

NPI: 1487565081
Provider Name (Legal Business Name): MACIEJ ZAWADZKI OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CLAY BANK RD
FAIRFIELD CA
94533-1655
US

IV. Provider business mailing address

3710 HARMONY WAY
CONCORD CA
94519-1714
US

V. Phone/Fax

Practice location:
  • Phone: 707-399-4840
  • Fax:
Mailing address:
  • Phone: 707-399-4840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: