Provider Demographics
NPI:1528622461
Name:HOSSEINI, CHIANA J (OTR/L)
Entity type:Individual
Prefix:
First Name:CHIANA
Middle Name:J
Last Name:HOSSEINI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHIANA
Other - Middle Name:
Other - Last Name:CLOUDTREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1344 ROSEMARY LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3728
Mailing Address - Country:US
Mailing Address - Phone:510-387-1422
Mailing Address - Fax:
Practice Address - Street 1:3687 MT DIABLO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3777
Practice Address - Country:US
Practice Address - Phone:925-954-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA25121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician