Active NPI
Shannon McClure Osborne
- Occupational Therapy Assistant
- Hayward, CA
National Provider Identifier
1972993863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 1129
- Practice address
- 25919 Gading Rd
Hayward, CA 94544-2725 - Phone
- (510) 782-8424
- Fax
- (510) 782-0199
- NPI assigned
- Jan 29, 2015
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | OTA 1129 | CA | Primary |
Addresses
Primary practice location
25919 Gading Rd
Hayward, CA 94544-2725
Mailing address
3219 San Carvante Way
Union City, CA 94587-2722
Phone (510) 861-3092
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 |
|---|---|---|---|
| OTA 1129 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1972993863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3219 SAN CARVANTE WAY",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945872722",
"telephone_number": "510-861-3092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25919 GADING RD",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945442725",
"telephone_number": "510-782-8424",
"fax_number": "510-782-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORNE",
"first_name": "SHANNON",
"middle_name": "MCCLURE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-29",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "OTA 1129",
"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 Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.