Healthcare Provider Details

I. General information

NPI: 1104770056
Provider Name (Legal Business Name): RUBY SHAPIRO OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 PARKER RD
RICHMOND CA
94806-2742
US

IV. Provider business mailing address

3000 PARKER RD
RICHMOND CA
94806-2742
US

V. Phone/Fax

Practice location:
  • Phone: 510-307-4630
  • Fax:
Mailing address:
  • Phone: 510-307-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT21835
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: