MEDICARE: REACH BEYOND THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center
2	225X00000X	Occupational Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1407722697	OTHER	CA	MEDICARE

General Provider Information

NPI Number	:	1447099007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACH BEYOND THERAPY INC

Provider Business Mailing Address
First Line	:	2703 ROCKEFELLER LN APT 2
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-4299
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 ARTESIA BLVD STE 305F
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3269
Country	:	US
Telephone Number	:	808-285-5090
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JADE WONG
Credential	:	OTR/L, CHT
Telephone Number	:	808-285-5090

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	11/18/2025

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Directions to “REACH BEYOND THERAPY INC ” Practice Location

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