Healthcare Provider Details

I. General information

NPI: 1750674479
Provider Name (Legal Business Name): YES I CAN OCCUPATIONAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 03/09/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 AMAR ROAD SUITE B13
WALNUT CA
91789
US

IV. Provider business mailing address

1050 LAKES DRIVE SUITE 225
WEST COVINA CA
91790
US

V. Phone/Fax

Practice location:
  • Phone: 909-615-6638
  • Fax:
Mailing address:
  • Phone: 909-615-6638
  • Fax: 626-667-7968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT 1109
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARY ELLEN FLORENDO-TAN
Title or Position: PRESIDENT
Credential: OTR/L
Phone: 909-615-6638