Provider Demographics
NPI:1700593530
Name:OCKULY, LINDY (OTD)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:
Last Name:OCKULY
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5342 MONTE VERDE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-3806
Mailing Address - Country:US
Mailing Address - Phone:419-852-4458
Mailing Address - Fax:
Practice Address - Street 1:3687 MT DIABLO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3777
Practice Address - Country:US
Practice Address - Phone:925-954-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist