Provider Demographics
NPI:1386442408
Name:OTEA HEALTH & ACUPCUNTURE PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:OTEA HEALTH & ACUPCUNTURE PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:BUSAN
Authorized Official - Last Name:BROPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, OTR/L
Authorized Official - Phone:408-355-5430
Mailing Address - Street 1:3201 ACORN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-3004
Mailing Address - Country:US
Mailing Address - Phone:408-355-5430
Mailing Address - Fax:
Practice Address - Street 1:2100 FOREST AVE STE 111
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1422
Practice Address - Country:US
Practice Address - Phone:408-818-8004
Practice Address - Fax:408-400-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty