Provider Demographics
NPI:1699421792
Name:LI, SCARLETT CLARE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SCARLETT
Middle Name:CLARE
Last Name:LI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4776 JAQUES CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2533
Mailing Address - Country:US
Mailing Address - Phone:510-449-5913
Mailing Address - Fax:
Practice Address - Street 1:2400 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5332
Practice Address - Country:US
Practice Address - Phone:510-449-5913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-27
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA21290OtherCBOT