Provider Demographics
NPI:1588245393
Name:GRANT, RIZZA (BA, MS, OTR/L)
Entity type:Individual
Prefix:
First Name:RIZZA
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:BA, MS, OTR/L
Other - Prefix:
Other - First Name:RIZZA
Other - Middle Name:JANE
Other - Last Name:HOSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1519 BROADWAY APT D
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3059
Mailing Address - Country:US
Mailing Address - Phone:510-333-7119
Mailing Address - Fax:
Practice Address - Street 1:1025 ATLANTIC AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1187
Practice Address - Country:US
Practice Address - Phone:510-618-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17314225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation