Provider Demographics
NPI:1164918983
Name:TANG, EVELYN (OTR)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 S MARY AVE APT 47
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7578
Mailing Address - Country:US
Mailing Address - Phone:408-857-5386
Mailing Address - Fax:
Practice Address - Street 1:20996 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5918
Practice Address - Country:US
Practice Address - Phone:510-537-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand