Provider Demographics
NPI:1386312460
Name:CHYAN, AMY BRIANNA
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:BRIANNA
Last Name:CHYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 N 1ST ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5300
Mailing Address - Country:US
Mailing Address - Phone:408-384-4993
Mailing Address - Fax:408-856-1246
Practice Address - Street 1:556 N 1ST ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5300
Practice Address - Country:US
Practice Address - Phone:408-384-4993
Practice Address - Fax:408-856-1246
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist