Active NPI
Jenny Lane, MS, OTR/L
- Occupational Therapist
- San Bernardino, CA
National Provider Identifier
1427398619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12580
- Practice address
- 5620 Mason Dr
San Bernardino, CA 92407-0246 - Phone
- (909) 887-9523
- NPI assigned
- Feb 25, 2013
- Last updated
- Feb 25, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12580 | CA | Primary |
Addresses
Primary practice location
5620 Mason Dr
San Bernardino, CA 92407-0246
Mailing address
5620 Mason Dr
San Bernardino, CA 92407-0246
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": "1361750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1427398619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5620 MASON DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924070246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5620 MASON DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924070246",
"telephone_number": "909-887-9523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "JENNY",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-25",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "12580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.