Individual provider Active NPI

Jennifer Michelle Kornoff, M.S. OT

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1205063351
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11901 Issued in CA
Practice address
6991 Balboa Ave
San Diego, CA 92111-3447
Phone
(858) 496-8232
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11901 CA Primary

Addresses

Primary practice location

6991 Balboa Ave
San Diego, CA 92111-3447

Mailing address

6991 Balboa Ave
San Diego, CA 92111-3447
Phone (858) 496-8232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1205063351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6991 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113447",
            "telephone_number": "858-496-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6991 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113447",
            "telephone_number": "858-496-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNOFF",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.S. OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "11901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.