Organization
WHOLE KIDS THERAPY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOIRA SULLIVAN OTR/L (PRESIDENT)
(408) 280-7712
Entity
Organization
Contact information
Practice address
2066 CLARMAR WAY STE A, SAN JOSE, CA 95128-1715
(408) 280-7712
(408) 280-7721
Mailing address
2066 CLARMAR WAY STE A, SAN JOSE, CA 95128-1715
(408) 280-7712
(408) 280-7721
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT3384
CA
Other
Enumeration date
07/21/2017
Last updated
08/22/2017
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