Justin Zarrett Blake

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

15099 Hesperian Blvd
San Leandro, CA 94578-3545

Phone

(510) 276-0118

NPI assigned

Jun 21, 2021

Reactivated

Mar 21, 2023

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Occupational Therapy Training Program San Francisco

  • Early Intervention Provider Agency
  • San Francisco, CA
  • NPI 1497209217
  NPD (past)
• Special Service for Groups, Inc.

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1831642115
  NPD (past)

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1841869153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15099 HESPERIAN BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15099 HESPERIAN BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783545",
            "telephone_number": "510-276-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JUSTIN",
        "middle_name": "ZARRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "deactivation_date": "2022-07-21",
        "reactivation_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinn Blackledge
• Sydnie Blackwood
• Linda Blaine
• Adena Blair, RN
• Andrew Blair
• Kimberly Blakiston, RN, MSN, PHN
• Alice Tangi Blancaflor, DMD
• Blanchette Chiropractic Corp
• Corey Andrew Blanchette, DC
• Lorna Bland, MD

• Occupational Therapist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.