Healthcare Provider Details

I. General information

NPI: 1164367629
Provider Name (Legal Business Name): JANINE LAU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 LAFAYETTE ST
SANTA CLARA CA
95050-2602
US

IV. Provider business mailing address

5175 WESTPORT WAY
UNION CITY CA
94587-5162
US

V. Phone/Fax

Practice location:
  • Phone: 408-743-5332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: