Healthcare Provider Details

I. General information

NPI: 1578426060
Provider Name (Legal Business Name): CARA MAMOLA OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2686 SPRING ST
REDWOOD CITY CA
94063-3522
US

IV. Provider business mailing address

2686 SPRING ST
REDWOOD CITY CA
94063-3522
US

V. Phone/Fax

Practice location:
  • Phone: 650-368-3345
  • Fax: 650-507-4071
Mailing address:
  • Phone: 650-368-3345
  • Fax: 650-507-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: