Provider Demographics
NPI:1124402623
Name:CHILDREN'S THERAPY CENTER, CO.
Entity Type:Organization
Organization Name:CHILDREN'S THERAPY CENTER, CO.
Other - Org Name:ALMADEN VALLEY CHILDREN'S THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINERTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:408-601-0993
Mailing Address - Street 1:6501 CROWN BLVD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2903
Mailing Address - Country:US
Mailing Address - Phone:408-601-0993
Mailing Address - Fax:
Practice Address - Street 1:6501 CROWN BLVD
Practice Address - Street 2:SUITE 100A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2903
Practice Address - Country:US
Practice Address - Phone:408-601-0993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
CA11778251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty