Individual
MIA KODAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4733 CHABOT DR STE 203, PLEASANTON, CA 94588-3972
(408) 559-9020
Mailing address
2101 ALEXANDER WAY, PLEASANTON, CA 94588-8307
(408) 559-9020
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA919
CA
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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