Provider Demographics
NPI:1053607374
Name:TINSON, ANGELA ALLISON (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ALLISON
Last Name:TINSON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1450 VETERANS BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2619
Mailing Address - Country:US
Mailing Address - Phone:408-733-3670
Mailing Address - Fax:408-245-7968
Practice Address - Street 1:2039 FOREST AVE
Practice Address - Street 2:104
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4817
Practice Address - Country:US
Practice Address - Phone:408-279-8501
Practice Address - Fax:408-279-8504
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA6589225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA123025Medicare PIN