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General NPI Number Information
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NPI Number | 1386442408
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Entity Type | Organization
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Legal Business Name | OTEA HEALTH & ACUPUNCTURE PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2100 FOREST AVE STE 111
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City | SAN JOSE
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State | CA
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Zip | 95128-1422
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Country | US
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Telephone | 408-818-8004
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Fax | 408-400-3306
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Provider Business Mailing Address
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Address Line | 3201 ACORN WAY
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City | SAN JOSE
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State | CA
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Zip | 95117-3004
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Country | US
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Telephone | 408-355-5430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA BUSAN BROPHY
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Credential | L.AC, OTR/L
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Telephone | 408-355-5430
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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