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Individual

MRS. JANIS NODA IKEDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
600 S 15TH ST, SAN JOSE, CA 95112-2367
(408) 286-9808
Mailing address
600 S 15TH ST, SAN JOSE, CA 95112-2367
(408) 286-9808

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3688
CA
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
3688
CA

Other

Enumeration date
09/26/2011
Last updated
09/26/2011
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