Provider Demographics
NPI:1780272732
Name:LAI, CLARICE WING YAN (OTR/L)
Entity type:Individual
Prefix:
First Name:CLARICE
Middle Name:WING YAN
Last Name:LAI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CLARICE
Other - Middle Name:
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:551 NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2229
Mailing Address - Country:US
Mailing Address - Phone:415-646-6790
Mailing Address - Fax:
Practice Address - Street 1:452 GRAND ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2062
Practice Address - Country:US
Practice Address - Phone:650-366-0486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14845225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics