Basic Information
Provider Information
NPI: 1275823775
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIORI
FirstName: LANA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 246 SOBRANTE WAY
Address2:  
City: SUNNYVALE
State: CA
PostalCode: 940864807
CountryCode: US
TelephoneNumber: 4087333670
FaxNumber: 4082457968
Practice Location
Address1: 2039 FOREST AVE
Address2: #104
City: SAN JOSE
State: CA
PostalCode: 951284817
CountryCode: US
TelephoneNumber: 4082798501
FaxNumber: 4082798504
Other Information
ProviderEnumerationDate: 04/18/2011
LastUpdateDate: 07/11/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT 4647CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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