Provider Demographics
NPI:1306829619
Name:TAYLAN, OZELLEAH U (OT)
Entity Type:Individual
Prefix:
First Name:OZELLEAH
Middle Name:U
Last Name:TAYLAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:OZELLEAH
Other - Middle Name:G
Other - Last Name:UDTUJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:246 SOBRANTE WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-4807
Mailing Address - Country:US
Mailing Address - Phone:408-733-3670
Mailing Address - Fax:408-245-7968
Practice Address - Street 1:246 SOBRANTE WAY
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-4807
Practice Address - Country:US
Practice Address - Phone:408-733-3670
Practice Address - Fax:408-245-7968
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT6829225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA111910Medicare UPIN