Healthcare Provider Details

I. General information

NPI: 1750978680
Provider Name (Legal Business Name): JAMAE DENISE DECUIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 PLUMAS ST
RENO NV
89509-4515
US

IV. Provider business mailing address

215 DIAS CIR
PITTSBURG CA
94565-5053
US

V. Phone/Fax

Practice location:
  • Phone: 775-433-2700
  • Fax:
Mailing address:
  • Phone: 510-672-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2942
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: