MEDICARE: MR. DANIEL MULLANEY OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	19787	CA

General Provider Information

NPI Number	:	1023941937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL MULLANEY OTR/L

Provider Business Mailing Address
First Line	:	645 40TH ST
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94805-1809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1731 PRINCE ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-2464
Country	:	US
Telephone Number	:	510-644-6313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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