Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT433 | CA |
NPI | 1003497348 |
---|---|
Provider Name | Oi Lan Jen |
First Address | Milpitas, CA 95035-6685 |
Second Address | Manteca, CA 95336-8271 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2021 |
Last Update Date | 19/04/2021 |