Healthcare Provider Details

I. General information

NPI: 1043126204
Provider Name (Legal Business Name): KIYOMI DING OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 WARMWOOD LN
SAN JOSE CA
95132-1251
US

IV. Provider business mailing address

1510 BOND ST
MILPITAS CA
95035-3856
US

V. Phone/Fax

Practice location:
  • Phone: 408-816-2018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: