MEDICARE: MATTHEW PHILLIPS 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		CA

General Provider Information

NPI Number	:	1063344380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW PHILLIPS OTR/L

Provider Business Mailing Address
First Line	:	2020 BONAR ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1793
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1460 EIGHTH ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-1434
Country	:	US
Telephone Number	:	510-644-6339
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MATTHEW PHILLIPS OTR/L” Practice Location

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