Provider Demographics
NPI:1841461555
Name:MEHTA, JYOTI (OT)
Entity type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 SOBRANTE WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-4807
Mailing Address - Country:US
Mailing Address - Phone:408-733-3670
Mailing Address - Fax:408-733-3670
Practice Address - Street 1:2039 FOREST AVE
Practice Address - Street 2:#104
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4817
Practice Address - Country:US
Practice Address - Phone:408-279-8501
Practice Address - Fax:408-279-8504
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7669225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist