Jennifer Lee Bryan, OTL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT3052 Issued in CA

Practice address

222 W Pine St
Lodi, CA 95240-2020

Phone

(209) 368-1009

Fax

(209) 368-1024

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovative Senior Rehabilitation Services Inc.

  • Physical Therapist
  • Lodi, CA
  • NPI 1184786089

  Occupational Therapist

  NPD (past)
• Innovative Senior Rehabilitation Services, Inc.

  • Physical Therapist
  • Stockton, CA
  • NPI 1437472636

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1497804207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-368-1009",
            "fax_number": "209-368-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-368-1009",
            "fax_number": "209-368-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "OTL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT3052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00945625",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angie E Brown, LVN
• Ayanna Brown, M.S.
• Laura Brown
• Cyndi Brunelli
• Leyla T Brusatori, PHD
• Marvin D Bryant
• Katharine Cagle Bryda, LMFT
• Manjeet K Bryson, NP RN
• Sara Buchman, PHARMD
• Kevin Buckman, MD

• Occupational Therapist in Lodi, CA
• Providers in Lodi, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.