Active NPI
Mary R Clements, OTR
- Occupational Therapist
- Hayward, CA
National Provider Identifier
1609947175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4642
- Practice address
- 1028 Incline CT
Hayward, CA 94541-4620 - Phone
- (510) 783-4385
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4642 | CA | Primary |
Addresses
Primary practice location
1028 Incline CT
Hayward, CA 94541-4620
Mailing address
1028 Incline CT
Hayward, CA 94541-4620
Phone (510) 783-4385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4642 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609947175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1028 INCLINE CT",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945414620",
"telephone_number": "510-783-4385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1028 INCLINE CT",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945414620",
"telephone_number": "510-783-4385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENTS",
"first_name": "MARY",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "4642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.