Healthcare Provider Details

I. General information

NPI: 1679961296
Provider Name (Legal Business Name): MAUREEN O'SHAY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JESSIE AVE
SACRAMENTO CA
95838-2609
US

IV. Provider business mailing address

6427 LAGUNA MIRAGE LN
ELK GROVE CA
95758-5464
US

V. Phone/Fax

Practice location:
  • Phone: 916-922-7177
  • Fax:
Mailing address:
  • Phone: 916-216-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT 13767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: