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General NPI Number Information
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NPI Number | 1669862439
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Entity Type | Organization
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Legal Business Name | ANDREA S. HANCOCK
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 40231 HACIENDA CT
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City | FREMONT
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State | CA
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Zip | 94539-3607
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Country | US
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Telephone | 510-378-7852
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Fax |
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Provider Business Mailing Address
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Address Line | 40231 HACIENDA CT
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City | FREMONT
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State | CA
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Zip | 94539-3607
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Country | US
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Telephone | 510-378-7852
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Fax |
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Authorized Official
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Title or Position | SELF-EMPLOYED
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Name | ANDREA HANCOCK
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Credential | OTR/L
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Telephone | 510-378-7852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 6071
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License Number State | CA
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