Provider Demographics
NPI:1801563168
Name:HILDEBRANDT, COURTNEY (OTR)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HILDEBRANDT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 N REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1517
Mailing Address - Country:US
Mailing Address - Phone:507-317-8157
Mailing Address - Fax:
Practice Address - Street 1:899 E CHARLESTON RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4644
Practice Address - Country:US
Practice Address - Phone:650-433-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist