Healthcare Provider Details

I. General information

NPI: 1649192568
Provider Name (Legal Business Name): J HEALING CLINIC OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 HILLTOP DR APT 31
REDDING CA
96003-3238
US

IV. Provider business mailing address

275 HILLTOP DR APT 31
REDDING CA
96003-3238
US

V. Phone/Fax

Practice location:
  • Phone: 714-714-5597
  • Fax:
Mailing address:
  • Phone: 714-714-5597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KYUNG-RAN TAE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: OTR/L
Phone: 714-714-5597