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General NPI Number Information
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NPI Number | 1386512747
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Entity Type | Individual
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Provider Name | MITZI ANN MERRILL X OT
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Gender | Female
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 200 MUIR RD
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City | MARTINEZ
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State | CA
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Zip | 94553-4672
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Country | US
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Telephone | 925-313-4520
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Fax |
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Provider Business Mailing Address
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Address Line | 430 MERRITT AVE APT 201
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City | OAKLAND
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State | CA
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Zip | 94610-5100
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Country | US
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Telephone | 925-313-4520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 5968
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License Number State | CA
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