Healthcare Provider Details

I. General information

NPI: 1124766100
Provider Name (Legal Business Name): THOMAS JAMES FOX OTD, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 54TH ST
OAKLAND CA
94608-3142
US

IV. Provider business mailing address

1390 MARKET ST APT 2222
SAN FRANCISCO CA
94102-5315
US

V. Phone/Fax

Practice location:
  • Phone: 925-984-3512
  • Fax:
Mailing address:
  • Phone: 925-984-3512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT27430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: