Provider Demographics
NPI:1023557741
Name:SNEAD, BRENT (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:SNEAD
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 FOREST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1444
Mailing Address - Country:US
Mailing Address - Phone:415-341-3498
Mailing Address - Fax:
Practice Address - Street 1:159 FOREST VIEW DR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1444
Practice Address - Country:US
Practice Address - Phone:415-341-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 14321225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA324879OtherNATIONAL BOARD OF OCCUPATIONAL THERAPY
CAOT 14321OtherCALIFORNIA BOARD OF OCCUPATIONAL THERAPY