Provider Demographics
NPI:1164276564
Name:HAND OVER HAND OT
Entity Type:Organization
Organization Name:HAND OVER HAND OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:310-922-4912
Mailing Address - Street 1:171 BRANHAM LN STE 10
Mailing Address - Street 2:PMB 1060
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136
Mailing Address - Country:US
Mailing Address - Phone:310-922-4912
Mailing Address - Fax:
Practice Address - Street 1:3792 MASTERS CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1543
Practice Address - Country:US
Practice Address - Phone:310-922-4912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty