Individual
GLENN HANDOKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1291 S BERNARDO AVE, SUNNYVALE, CA 94087-2060
(408) 245-8070
Mailing address
888 REDBIRD DR, SAN JOSE, CA 95125-2823
(408) 623-8284
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
459315
NBCOT
—
Enumeration date
09/07/2021
Last updated
09/07/2021
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