Healthcare Provider Details

I. General information

NPI: 1841107919
Provider Name (Legal Business Name): SAMANTHA JANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 N 1ST ST
SAN JOSE CA
95131-2022
US

IV. Provider business mailing address

3123 PROMONTORY WAY
SAN JOSE CA
95135-2230
US

V. Phone/Fax

Practice location:
  • Phone: 408-337-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: