Provider Demographics
NPI:1881222339
Name:NGUYEN, ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:NGUYEN
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 1:3420 JUDI ANN CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4336
Mailing Address - Country:US
Mailing Address - Phone:408-387-2988
Mailing Address - Fax:
Practice Address - Street 1:20400 SARATOGA LOS GATOS ROAD
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-5927
Practice Address - Country:US
Practice Address - Phone:800-967-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist