Healthcare Provider Details

I. General information

NPI: 1053647156
Provider Name (Legal Business Name): EMI TENAYA UENAKA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 THE ALAMEDA
SAN JOSE CA
95126-1141
US

IV. Provider business mailing address

2145 THE ALAMEDA
SAN JOSE CA
95126-1141
US

V. Phone/Fax

Practice location:
  • Phone: 408-248-6886
  • Fax: 408-248-4923
Mailing address:
  • Phone: 408-248-6886
  • Fax: 408-248-4923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: