Healthcare Provider Details

I. General information

NPI: 1699692400
Provider Name (Legal Business Name): JENNIFER ANDAYA-LAMBINICIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LAMBINICIO EDM, OTR/L, ATP

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 RIDDER PARK DR
SAN JOSE CA
95131-2304
US

IV. Provider business mailing address

4655 GRIFFITH AVE
FREMONT CA
94538-3323
US

V. Phone/Fax

Practice location:
  • Phone: 510-303-0261
  • Fax:
Mailing address:
  • Phone: 510-303-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9811
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: