Active NPI
Jeremy Luena, COTA/L
- Physical Rehabilitation Occupational Therapist
- Santa Rosa, CA
National Provider Identifier
1396419818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 5317
- Practice address
- 4650 Hoen Ave
Santa Rosa, CA 95405-9407 - Phone
- (707) 546-0471
- NPI assigned
- Aug 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 5317 | CA | Primary |
Addresses
Primary practice location
4650 Hoen Ave
Santa Rosa, CA 95405-9407
Mailing address
910 Kay Ave
Trinidad, CA 95570-9727
Phone (860) 301-4739
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5317 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628294400000",
"number": "1396419818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 KAY AVE",
"city": "TRINIDAD",
"state": "CA",
"postal_code": "955709727",
"telephone_number": "860-301-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 HOEN AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954059407",
"telephone_number": "707-546-0471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUENA",
"first_name": "JEREMY",
"name_prefix": "Mr.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-07",
"last_updated": "2021-08-07",
"certification_date": "2021-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "CA",
"license": "5317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.