Anisha Antony, OT

Individual provider Active NPI Occupational Therapist · Salt Lake City, UT

NPI 1265709117 · NPPES record last updated May 13, 2013

Key facts

NPI
1265709117
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT60248702 (WA)
Practice address
1952 E 7000 S
Salt Lake City, UT 84121-6877
Phone
(801) 859-9211
Fax
(801) 495-5303
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Fun Zone Kids Therapy Current Accepting new patients

Locations

6489 Camden Ave
Ste 106
San Jose, CA 95120

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT60248702 WA Yes

Addresses

Primary practice location

1952 E 7000 S
Salt Lake City, UT 84121-6877

Mailing address

PO Box 711185
Salt Lake City, UT 84171-1185
Phone (800) 574-4792

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Occupational Therapist in Utah

Sources for this page

Verify at the official NPI Registry.