Healthcare Provider Details

I. General information

NPI: 1811880644
Provider Name (Legal Business Name): SHERRY YEAGER OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US

IV. Provider business mailing address

190A MIDHILL RD
MARTINEZ CA
94553-4202
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5750
  • Fax:
Mailing address:
  • Phone: 925-586-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: