Provider Demographics
NPI:1316364052
Name:FARR, LISA YI (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:YI
Last Name:FARR
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 REGAS DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4917
Mailing Address - Country:US
Mailing Address - Phone:512-632-6719
Mailing Address - Fax:
Practice Address - Street 1:691 REGAS DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-4917
Practice Address - Country:US
Practice Address - Phone:512-632-6719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11512225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist