Provider Demographics
NPI:1770600322
Name:EL CERRITO HAND THERAPY & ACUPUNCTURE REHAB. INC
Entity type:Organization
Organization Name:EL CERRITO HAND THERAPY & ACUPUNCTURE REHAB. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:OTR
Authorized Official - Phone:510-525-2700
Mailing Address - Street 1:6328 FAIRMOUNT AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3611
Mailing Address - Country:US
Mailing Address - Phone:510-525-2700
Mailing Address - Fax:510-525-2716
Practice Address - Street 1:6328 FAIRMOUNT AVE STE 220
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3611
Practice Address - Country:US
Practice Address - Phone:510-525-2700
Practice Address - Fax:510-525-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ64666ZOtherANTHEM BLUE CROSS
CAZZZ29723ZOtherPTAN