Individual
LORRAINE CAROL NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3310 ROBINSON DRIVE, OAKLAND, CA 94602-4136
(408) 821-9165
Mailing address
3310 ROBINSON DRIVE, OAKLAND, CA 94602-4136
(408) 821-9165
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
OT 11629
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558392423
MEDICARE
CA
Enumeration date
02/20/2012
Last updated
02/20/2012
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