Individual
WANDA G SHIOTSUKA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
10565 BRUNSWICK ROAD, GRASS VALLEY, CA 95945-9053
(530) 273-4152
(530) 273-4153
Mailing address
PO BOX 612260, SAN JOSE, CA 95161
(877) 325-2776
(408) 945-4011
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT 5422
CA
225XH1200X
Hand Occupational Therapist
Primary
OT 5422
CA
Other
Enumeration date
12/14/2005
Last updated
09/11/2025
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