Provider Demographics
NPI:1447721204
Name:FELIX, DAVID-MICHAEL (COTA/L)
Entity type:Individual
Prefix:
First Name:DAVID-MICHAEL
Middle Name:
Last Name:FELIX
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 RICHARDSON CT
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4151
Mailing Address - Country:US
Mailing Address - Phone:407-620-9691
Mailing Address - Fax:
Practice Address - Street 1:1267 MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5210
Practice Address - Country:US
Practice Address - Phone:408-265-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3644224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant