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General NPI Number Information
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NPI Number | 1255068722
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Entity Type | Individual
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Provider Name | ANGELA ACOSTA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 275 SARATOGA AVE STE 160
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City | SANTA CLARA
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State | CA
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Zip | 95050-6668
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Country | US
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Telephone | 408-337-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 BRADDOCK CT
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City | SAN JOSE
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State | CA
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Zip | 95125-5950
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Country | US
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Telephone | 909-894-9572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 23104
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License Number State | CA
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