Healthcare Provider Details

I. General information

NPI: 1063242576
Provider Name (Legal Business Name): HAND THERAPY CAPITOLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 42ND AVE
CAPITOLA CA
95010-3535
US

IV. Provider business mailing address

650 TABOR DR
SCOTTS VALLEY CA
95066-2843
US

V. Phone/Fax

Practice location:
  • Phone: 831-234-5904
  • Fax: 831-480-1321
Mailing address:
  • Phone: 831-234-5904
  • Fax: 831-480-1321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. KERRI J COLBERT
Title or Position: BUSINESS OWNER
Credential: OTL
Phone: 831-234-5904