Organization
ERGOTHERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRICELDA CID OTR (OWNER)
(310) 920-9104
Entity
Organization
Contact information
Practice address
3345 GRAND AVE STE 3, OAKLAND, CA 94610-2772
(510) 774-2755
Mailing address
490 LAKE PARK AVE UNIT 10583, OAKLAND, CA 94610-8021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/08/2023
Last updated
11/10/2023
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