Provider Demographics
NPI:1982978201
Name:ENGELGAU, ANN BAYCI (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:BAYCI
Last Name:ENGELGAU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:BAYCI
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:121 SARATOGA AVE
Mailing Address - Street 2:APT. 4109
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7348
Mailing Address - Country:US
Mailing Address - Phone:248-854-5807
Mailing Address - Fax:
Practice Address - Street 1:121 SARATOGA AVE
Practice Address - Street 2:APT. 4109
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7348
Practice Address - Country:US
Practice Address - Phone:248-854-5807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12388225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist