Active NPI
Brandon S Luong, OTR/L
- Pediatric Occupational Therapist
- San Jose, CA
National Provider Identifier
1467950279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 23737
- Practice address
- 911 Bern CT Ste 130
San Jose, CA 95112-1242 - Phone
- (408) 437-8864
- Fax
- (408) 437-8865
- NPI assigned
- Jan 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Pediatric Occupational Therapist | 225XP0200X | 23737 | CA | Primary |
Addresses
Primary practice location
911 Bern CT Ste 130
San Jose, CA 95112-1242
Mailing address
911 Bern CT
San Jose, CA 95112-1242
Phone (408) 437-8864
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 |
|---|---|---|---|
| 23737 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Santa Clara | Past | Accepting new patients | |
| Integrated Intervention for Children With Autism | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
-
- General Acute Care Hospital
- San Jose, CA
- NPI 1063406551
-
- Speech-Language Pathologist
- San Jose, CA
- NPI 1669725834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1467950279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 BERN CT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951121242",
"telephone_number": "408-437-8864",
"fax_number": "408-437-8865"
},
{
"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",
"fax_number": "408-437-8865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUONG",
"first_name": "BRANDON",
"middle_name": "S",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-26",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "23737",
"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 Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.