Provider Demographics
NPI:1932517117
Name:DESCAMP, DEANNA M (OTR/L)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:DESCAMP
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 1:5893 MANORWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4036
Mailing Address - Country:US
Mailing Address - Phone:408-472-3332
Mailing Address - Fax:
Practice Address - Street 1:39180 FARWELL DR
Practice Address - Street 2:SUITE 211
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1000
Practice Address - Country:US
Practice Address - Phone:510-857-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 12257225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand