Provider Demographics
NPI:1235168717
Name:GRACELY, CINDY CLAYTON (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:CLAYTON
Last Name:GRACELY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 OAK KNOLL LOOP
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5417
Mailing Address - Country:US
Mailing Address - Phone:925-946-9343
Mailing Address - Fax:
Practice Address - Street 1:2160 APPIAN WAY
Practice Address - Street 2:101
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2524
Practice Address - Country:US
Practice Address - Phone:510-724-1248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6442225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand