Healthcare Provider Details

I. General information

NPI: 1447099007
Provider Name (Legal Business Name): REACH BEYOND THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 ARTESIA BLVD STE 305F
REDONDO BEACH CA
90278-3269
US

IV. Provider business mailing address

2703 ROCKEFELLER LN APT 2
REDONDO BEACH CA
90278-4299
US

V. Phone/Fax

Practice location:
  • Phone: 808-285-5090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JADE WONG
Title or Position: OWNER
Credential: OTR/L, CHT
Phone: 808-285-5090