Individual provider Active NPI

Elaine Yen, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • San Jose, CA
National Provider Identifier
1962806745
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
12680 Issued in CA
Practice address
1203 Water Lily Way
San Jose, CA 95129-2866
Phone
(650) 307-2674
NPI assigned
Oct 22, 2014
Last updated
Oct 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 12680 CA Primary

Addresses

Primary practice location

1203 Water Lily Way
San Jose, CA 95129-2866

Mailing address

1203 Water Lily Way
San Jose, CA 95129-2866
Phone (650) 307-2674

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

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1962806745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 WATER LILY WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951292866",
            "telephone_number": "650-307-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 WATER LILY WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951292866",
            "telephone_number": "650-307-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "ELAINE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "12680",
            "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 Oct 22, 2014; 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.