Susan Jane Clark, OTR/L, CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT3169 Issued in CA

Practice address

450 Broadway St
Pavilion a, 2ND Floor
Redwood City, CA 94063-3132

Phone

(650) 721-7682

Fax

(650) 721-3423

NPI assigned

Mar 1, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1508994658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST",
            "address_2": "M/C 6122",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-721-7682",
            "fax_number": "650-721-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST",
            "address_2": "PAVILION A, 2ND FLOOR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-721-7682",
            "fax_number": "650-721-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Wing-on Chung, PHARM.D.
• Christopher Matthew Cincotta
• Carol Clancy, PSY.D.
• Jason R. Clark, MD
• Lisa Marie Clark
• Alexander Richard Clarke, M.D.
• Stella Q. Clavecilla, DO
• Sara Cline, CCC-SLP
• Laura Renee Close
• Toby Jane Coates

• Hand Occupational Therapist in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Hand Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.