Provider Demographics
NPI:1851853279
Name:VELAZQUEZ, VALERIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:VELAZQUEZ
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 1:6500 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1028
Mailing Address - Country:US
Mailing Address - Phone:415-994-8113
Mailing Address - Fax:
Practice Address - Street 1:6500 WHITNEY ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1028
Practice Address - Country:US
Practice Address - Phone:415-994-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT19769225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist