Provider Demographics
NPI:1821481029
Name:OKAJIMA, MASARU (MS, MOT, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MASARU
Middle Name:
Last Name:OKAJIMA
Suffix:
Gender:M
Credentials:MS, 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 1:4821 FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2930
Mailing Address - Country:US
Mailing Address - Phone:510-206-2896
Mailing Address - Fax:
Practice Address - Street 1:3030 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3411
Practice Address - Country:US
Practice Address - Phone:510-451-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15044225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist