MEDICARE: BAY AREA REHAB SPECIALISTS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225100000X	Physical Therapist
3	225200000X	Physical Therapy Assistant
4	225X00000X	Occupational Therapist
5	2355S0801X	Speech-Language Assistant
6	235Z00000X	Speech-Language Pathologist
7	225XP0019X	Physical Rehabilitation Occupational Therapist

General Provider Information

NPI Number	:	1992493555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA REHAB SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	1419 GRAND ST APT 102
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-2538
Country	:	US
Telephone Number	:	732-810-5532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 ALLSTON WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1920
Country	:	US
Telephone Number	:	510-848-8774
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LORENZO HERNANDEZ
Credential	:	OTR
Telephone Number	:	732-810-5532

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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