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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHANE DAVID NIBLEY

Active

SHANE DAVID NIBLEY is a Occupational Therapy Assistant healthcare provider located in SOUTH LAKE TAHOE, California. NPI 1255200846 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapy Assistant · SOUTH LAKE TAHOE, CA

Registration Details

NPI Number
1255200846
Provider Type
Individual
Gender
Male
NPI Issued
Nov 1, 2025 (0.60151104913416 yrs)
Last Updated
Dec 11, 2025

Practice Information

Address
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA, 961507976
Browse CA providers · Browse ZIP 96150
Phone
5309576254
Primary Specialty
Occupational Therapy Assistant
225400000X
Additional Specialty
Day Training/Habilitation

Other Occupational Therapy Assistant Providers in SOUTH LAKE TAHOE, CA

Name Credential NPI
EDWINA BAILEY RADT 1700603909
COURTNEY WOOD 1154128056
KATRINA GABRIELLE JOY RN 1215809199
DOREEN R HILL 1699636217
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.