MEDICARE: BETH DILLIN BETH DILLIN

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	225XP0200X	Pediatric Occupational Therapist	1617	CA

General Provider Information

NPI Number	:	1164759544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH DILLIN BETH DILLIN

Provider Business Mailing Address
First Line	:	2943 SOUTHWOOD DR
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1751
Country	:	US
Telephone Number	:	510-520-0047
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 18TH ST
Second Line	:
City	:	SAN PABLO
State	:	CA
Zip	:	94806-4703
Country	:	US
Telephone Number	:	510-231-1435
Fax Number	:

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

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	02/23/2026

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