Provider Demographics
NPI:1306220751
Name:SHAMSI, CRYSTAL LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:SHAMSI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT OTR/L
Mailing Address - Street 1:13446 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARTIN
Mailing Address - State:CA
Mailing Address - Zip Code:95046-9767
Mailing Address - Country:US
Mailing Address - Phone:954-551-7366
Mailing Address - Fax:
Practice Address - Street 1:13446 CENTER AVE
Practice Address - Street 2:
Practice Address - City:SAN MARTIN
Practice Address - State:CA
Practice Address - Zip Code:95046-9767
Practice Address - Country:US
Practice Address - Phone:954-551-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 15261225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics