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General NPI Number Information
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NPI Number | 1588245393
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Entity Type | Individual
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Provider Name | RIZZA GRANT BA, MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1025 ATLANTIC AVE STE 100
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City | ALAMEDA
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State | CA
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Zip | 94501-1187
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Country | US
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Telephone | 510-618-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 1519 BROADWAY APT D
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City | ALAMEDA
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State | CA
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Zip | 94501-3059
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Country | US
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Telephone | 510-333-7119
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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 | 17314
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License Number State | CA
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