Provider Demographics
NPI:1417149402
Name:YAMAKOSHI, SCOTT TAKEO (PT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:TAKEO
Last Name:YAMAKOSHI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:900 S WINCHESTER BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2901
Mailing Address - Country:US
Mailing Address - Phone:408-241-7033
Mailing Address - Fax:408-241-7027
Practice Address - Street 1:900 S WINCHESTER BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2901
Practice Address - Country:US
Practice Address - Phone:408-241-7033
Practice Address - Fax:408-241-7027
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT152752251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics