Healthcare Provider Details

I. General information

NPI: 1659217248
Provider Name (Legal Business Name): VANESSA NELSON MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 PINOLE VALLEY RD
PINOLE CA
94564-1429
US

IV. Provider business mailing address

2900 PINOLE VALLEY RD
PINOLE CA
94564-1429
US

V. Phone/Fax

Practice location:
  • Phone: 510-307-4648
  • Fax:
Mailing address:
  • Phone: 510-307-4648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: