Healthcare Provider Details

I. General information

NPI: 1972473049
Provider Name (Legal Business Name): ALIFYA NAGRI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WALNUT DR
SAN RAMON CA
94583-5312
US

IV. Provider business mailing address

3978 STONERIDGE DR APT 3
PLEASANTON CA
94588-8352
US

V. Phone/Fax

Practice location:
  • Phone: 192-521-7878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number27229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: