Active NPI
Elaine M Chan, OTR/L
- Occupational Therapist
- Daly City, CA
National Provider Identifier
1043581390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9277
- Practice address
- 632 Orange St
Daly City, CA 94014-2848 - Phone
- (510) 717-0789
- NPI assigned
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 9277 | CA | Primary |
Addresses
Primary practice location
632 Orange St
Daly City, CA 94014-2848
Mailing address
632 Orange St
Daly City, CA 94014-2848
Phone (510) 717-0789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9277 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1043581390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 ORANGE ST",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940142848",
"telephone_number": "510-717-0789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 ORANGE ST",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940142848",
"telephone_number": "510-717-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ELAINE",
"middle_name": "M",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "9277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daly City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.