Active NPI
Justin Mattiuzzo, OTR/L
- Occupational Therapist
- Modesto, CA
National Provider Identifier
1780300467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 3936 Lookout Dr
Modesto, CA 95355-9019 - Phone
- (209) 353-0580
- NPI assigned
- Oct 14, 2022
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
3936 Lookout Dr
Modesto, CA 95355-9019
Mailing address
3936 Lookout Dr
Modesto, CA 95355-9019
Phone (209) 353-0580
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1780300467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3936 LOOKOUT DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559019",
"telephone_number": "209-353-0580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3936 LOOKOUT DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559019",
"telephone_number": "209-353-0580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTIUZZO",
"first_name": "JUSTIN",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-14",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.