Provider Demographics
NPI:1376625350
Name:O'HURLEY, SIOBHAN MARIE (OTR L)
Entity Type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:MARIE
Last Name:O'HURLEY
Suffix:
Gender:F
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 1:2082 HOPE LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8628
Mailing Address - Country:US
Mailing Address - Phone:530-524-9010
Mailing Address - Fax:
Practice Address - Street 1:3278 BECHELLI LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2005
Practice Address - Country:US
Practice Address - Phone:530-223-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4528225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ58756Medicare UPIN