Provider Demographics
NPI:1689332546
Name:JO ELLEN TENNYSON SAMSON
Entity Type:Organization
Organization Name:JO ELLEN TENNYSON SAMSON
Other - Org Name:THE HAND THERAPY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:707-599-4074
Mailing Address - Street 1:240 WESTGATE DR STE 232
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2453
Mailing Address - Country:US
Mailing Address - Phone:831-531-8277
Mailing Address - Fax:831-576-7717
Practice Address - Street 1:240 WESTGATE DR STE 232
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2453
Practice Address - Country:US
Practice Address - Phone:831-531-8277
Practice Address - Fax:831-576-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty