Provider Demographics
NPI:1508039868
Name:CERTIFIED HAND REHABILITATION CENTER
Entity Type:Organization
Organization Name:CERTIFIED HAND REHABILITATION CENTER
Other - Org Name:CERTIFIED HAND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERENITY
Authorized Official - Middle Name:SIAN
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L,CHT
Authorized Official - Phone:925-683-2024
Mailing Address - Street 1:760 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:#100
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526
Mailing Address - Country:US
Mailing Address - Phone:925-743-8905
Mailing Address - Fax:925-743-9614
Practice Address - Street 1:760 SAN RAMON VALLEY BLVD
Practice Address - Street 2:#100
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526
Practice Address - Country:US
Practice Address - Phone:925-743-8905
Practice Address - Fax:925-743-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2879174400000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23835ZMedicare PIN