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General NPI Number Information
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NPI Number | 1790571545
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Entity Type | Organization
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Legal Business Name | LIFE IN MOTION THERAPY
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2170 THE ALAMEDA # 104
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City | SAN JOSE
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State | CA
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Zip | 95126-1131
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Country | US
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Telephone | 831-515-9951
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Fax | 831-515-3404
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Provider Business Mailing Address
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Address Line | 7960-B SOQUEL DRIVE #169
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City | APTOS
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State | CA
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Zip | 95003
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Country | US
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Telephone | 831-515-9951
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | YVONNE O'BRIEN
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Credential | LMFT
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Telephone | 831-818-7153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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