Individual provider Active NPI

Haruka Yamaguchi, OTR/L

  • Pediatric Occupational Therapist
  • San Jose, CA
National Provider Identifier
1073208260
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT24789 Issued in CA
Practice address
911 Bern CT Ste 130
San Jose, CA 95112-1242
Phone
(408) 437-8864
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT24789 CA Primary

Addresses

Primary practice location

911 Bern CT Ste 130
San Jose, CA 95112-1242

Mailing address

410 Milan Dr Unit 201
San Jose, CA 95134-2479
Phone (650) 255-2451

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

LicenseStateTypeSpecialty
OT24789CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara PastSince Apr 9, 2023 Accepting new patients
Integrated Intervention for Children With Autism PastSince Apr 9, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1073208260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MILAN DR UNIT 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342479",
            "telephone_number": "650-255-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BERN CT STE 130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121242",
            "telephone_number": "408-437-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAGUCHI",
        "first_name": "HARUKA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT24789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.