Healthcare Provider Details

I. General information

NPI: 1063469567
Provider Name (Legal Business Name): GOLDEN GATE HAND THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CALIFORNIA ST SUITE 450
SAN FRANCISCO CA
94109-4586
US

IV. Provider business mailing address

1700 CALIFORNIA ST SUITE 450
SAN FRANCISCO CA
94109-4586
US

V. Phone/Fax

Practice location:
  • Phone: 415-359-1444
  • Fax: 415-447-3868
Mailing address:
  • Phone: 415-359-1444
  • Fax: 415-447-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELANIE LYNN JOHNKE
Title or Position: DIRECTOR
Credential: OTR/L, CHT
Phone: 415-359-1444