Provider Demographics
NPI:1568782340
Name:NG, ALICE Y (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:Y
Last Name:NG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 ROBLES RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6774
Mailing Address - Country:US
Mailing Address - Phone:650-255-1838
Mailing Address - Fax:
Practice Address - Street 1:1838 ROBLES RANCH RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6774
Practice Address - Country:US
Practice Address - Phone:650-255-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 962225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist