Provider Demographics
NPI:1699046045
Name:OU, PATRICIA CHRISTINA (PT, L AC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CHRISTINA
Last Name:OU
Suffix:
Gender:F
Credentials:PT, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 PARK BLVD APT 8
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4836
Mailing Address - Country:US
Mailing Address - Phone:310-694-6636
Mailing Address - Fax:
Practice Address - Street 1:1220 UNIVERSITY DR STE 202B
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4262
Practice Address - Country:US
Practice Address - Phone:650-400-8946
Practice Address - Fax:408-962-0188
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17477171100000X
CAPT38000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT38000OtherPHYSICAL THERAPY BOARD OF CALIFORNIA