Provider Demographics
NPI:1477056273
Name:ACCESS THERAPY LLC
Entity Type:Organization
Organization Name:ACCESS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:VICENCIO
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:408-753-0775
Mailing Address - Street 1:3790 FONTVEILLE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-2147
Mailing Address - Country:US
Mailing Address - Phone:408-753-0775
Mailing Address - Fax:405-385-2511
Practice Address - Street 1:3790 FONTVEILLE CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-2147
Practice Address - Country:US
Practice Address - Phone:408-753-0775
Practice Address - Fax:405-385-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty