Healthcare Provider Details

I. General information

NPI: 1386442408
Provider Name (Legal Business Name): OTEA HEALTH & ACUPUNCTURE PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 FOREST AVE STE 111
SAN JOSE CA
95128-1422
US

IV. Provider business mailing address

3201 ACORN WAY
SAN JOSE CA
95117-3004
US

V. Phone/Fax

Practice location:
  • Phone: 408-818-8004
  • Fax: 408-400-3306
Mailing address:
  • Phone: 408-355-5430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA BUSAN BROPHY
Title or Position: OWNER
Credential: L.AC, OTR/L
Phone: 408-355-5430