Healthcare Provider Details

I. General information

NPI: 1346175312
Provider Name (Legal Business Name): JANE CHANG OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BREA CANYON RD STE 158
DIAMOND BAR CA
91789-3005
US

IV. Provider business mailing address

680 BREA CANYON RD STE 158
DIAMOND BAR CA
91789-3005
US

V. Phone/Fax

Practice location:
  • Phone: 840-588-9908
  • Fax: 909-274-7107
Mailing address:
  • Phone: 840-588-9908
  • Fax: 909-274-7107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT25510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: