Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Johnny Williams-Ray Defroe III, OTR/L

Individual provider Occupational Therapist · NPI 1821609264

Johnny Williams-Ray Defroe III, OTR/L is an Occupational Therapist in Stockton, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

6940 Pacific Ave
Stockton, CA 95207-2602
Phone: (209) 477-4817
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 21479 (CA)

Record details

NPI number1821609264
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedAugust 10, 2020
Last updated in NPPESAugust 10, 2020
Certification dateAugust 10, 2020

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