Provider Demographics
NPI:1780862441
Name:EL CERRITO HAND THERAPY
Entity Type:Organization
Organization Name:EL CERRITO HAND THERAPY
Other - Org Name:ORINDA HAND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUPPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-525-2700
Mailing Address - Street 1:6328 FAIRMOUNT AVE
Mailing Address - Street 2:STE220
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3665
Mailing Address - Country:US
Mailing Address - Phone:510-525-2700
Mailing Address - Fax:
Practice Address - Street 1:122 CAMINO PABLO
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2203
Practice Address - Country:US
Practice Address - Phone:510-525-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL CERRITO HAND THERAPY & ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29599ZOtherGROUP MC ID