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General NPI Number Information
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NPI Number | 1538311402
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Entity Type | Individual
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Provider Name | JASON TSE OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 28-2815 HAWAII BELT RD
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City | PEPEEKEO
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State | HI
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Zip | 96783-9678
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Country | US
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Telephone | 626-536-4519
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 831080
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City | PEPEEKEO
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State | HI
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Zip | 96783-1071
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Country | US
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Telephone | 626-536-4519
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT 10152
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-2466
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License Number State | HI
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