Basic Information
| Provider Information | |||||||||
| NPI: | 1134459530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OREILLY | ||||||||
| FirstName: | AIMEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 323 CYPRESS AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950506403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179552812 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1291 S BERNARDO AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082458070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2010 | ||||||||
| LastUpdateDate: | 03/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18821 | MA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 40183 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.