Provider Demographics
NPI:1467166256
Name:GO BEYOND PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:GO BEYOND PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIEN-YING
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-660-7128
Mailing Address - Street 1:1370 VALLEY VISTA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3921
Mailing Address - Country:US
Mailing Address - Phone:840-588-9908
Mailing Address - Fax:
Practice Address - Street 1:18800 AMAR RD STE A7
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-7100
Practice Address - Country:US
Practice Address - Phone:840-588-9908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2195Q989Medicaid