Ethel-Grace Victoria, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

4017 Issued in CA

Practice address

1150 Tilton Dr
Sunnyvale, CA 94087-2440

Phone

(916) 300-7854

NPI assigned

Jul 27, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Grace Victoria Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1003120551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 ELM LAKE CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951313900",
            "telephone_number": "408-313-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 TILTON DR",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872440",
            "telephone_number": "916-300-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "ETHEL-GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "4017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "VICTORIA",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Rehabilitation Occupational Therapist in Sunnyvale, CA
• Providers in Sunnyvale, CA by specialty
• Physical Rehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.