Provider Demographics
NPI:1780469361
Name:HOANG, DAN VI (COTA/L)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:VI
Last Name:HOANG
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21032 SCHOENBORN ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-2783
Mailing Address - Country:US
Mailing Address - Phone:805-668-1881
Mailing Address - Fax:
Practice Address - Street 1:21032 SCHOENBORN ST
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-2783
Practice Address - Country:US
Practice Address - Phone:805-668-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA5920224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant