Provider Demographics
NPI:1538894407
Name:YAO, CHRISTOPHER (OTA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:YAO
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9828 GARDEN GROVE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1655
Mailing Address - Country:US
Mailing Address - Phone:213-905-0449
Mailing Address - Fax:
Practice Address - Street 1:9828 GARDEN GROVE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1655
Practice Address - Country:US
Practice Address - Phone:213-905-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-23
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5323224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant