Provider Demographics
NPI:1821825647
Name:HAPPY BRAIN PEDIATRIC THERAPY PC
Entity type:Organization
Organization Name:HAPPY BRAIN PEDIATRIC THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NG WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-331-5305
Mailing Address - Street 1:6685 N EL CAPITAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-9787
Mailing Address - Country:US
Mailing Address - Phone:949-331-5305
Mailing Address - Fax:
Practice Address - Street 1:5275 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7007
Practice Address - Country:US
Practice Address - Phone:559-691-5831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty