Jennifer Willkomm, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

10640 Issued in CA

Practice address

1500 Sierra Dr
Arroyo Grande, CA 93420-2228

Phone

(805) 904-0016

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer Willkomm Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1184192759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934480428",
            "telephone_number": "805-478-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SIERRA DR",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202228",
            "telephone_number": "805-904-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLKOMM",
        "first_name": "JENNIFER",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "10640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILLKOMM",
            "prefix": "MS.",
            "credential": "OTR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Occupational Therapist in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.