Provider Demographics
NPI:1093049231
Name:SHIMER-LAL, RACHEL JANE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:SHIMER-LAL
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7349 BRIZA LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5043
Mailing Address - Country:US
Mailing Address - Phone:510-823-7964
Mailing Address - Fax:510-952-3600
Practice Address - Street 1:125 RYAN INDUSTRIAL CT
Practice Address - Street 2:205
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1772
Practice Address - Country:US
Practice Address - Phone:925-855-9810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 5457225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics