Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 19088 | CA |
NPI | 1194209320 |
---|---|
Provider Name | Pei Ju Ho |
First Address | San Jose, CA 95112-3165 |
Second Address | Fremont, CA 94536-5356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 24/09/2018 |