Provider Demographics
NPI:1275926727
Name:HANH PHAN SPEECH & OCCUPATIONAL THERAPY INC.
Entity Type:Organization
Organization Name:HANH PHAN SPEECH & OCCUPATIONAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANH
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SLP-CCC, OTR-L
Authorized Official - Phone:408-332-0259
Mailing Address - Street 1:6116 CAMINO VERDE DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1441
Mailing Address - Country:US
Mailing Address - Phone:408-332-0259
Mailing Address - Fax:
Practice Address - Street 1:6116 CAMINO VERDE DR
Practice Address - Street 2:SUITE 11
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1441
Practice Address - Country:US
Practice Address - Phone:408-332-0259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty