Healthcare Provider Details

I. General information

NPI: 1376455964
Provider Name (Legal Business Name): B.A.O. THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11204 FEATHERHILL LN
SAN DIEGO CA
92126-4872
US

IV. Provider business mailing address

11204 FEATHERHILL LN
SAN DIEGO CA
92126-4872
US

V. Phone/Fax

Practice location:
  • Phone: 408-207-5895
  • Fax:
Mailing address:
  • Phone: 408-207-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS HUONG NGUYEN
Title or Position: OWNER
Credential: OTR
Phone: 408-207-5895