Active NPI
Jennifer Jean Job, OTA-L
- Occupational Therapy Assistant
- Queen Creek, AZ
National Provider Identifier
1538375647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1313
- Practice address
- 3575 E Lawndale Place
Queen Creek, AZ 85242 - Phone
- (480) 818-3069
- Fax
- (480) 895-9889
- NPI assigned
- May 15, 2007
- 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 Therapy Assistant | 224Z00000X | 1313 | AZ | Primary |
Addresses
Primary practice location
3575 E Lawndale Place
Queen Creek, AZ 85242
Mailing address
3575 E Lawndale Place
Queen Creek, AZ 85242
Phone (480) 818-3069
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 |
|---|---|---|---|
| 1313 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538375647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3575 E LAWNDALE PLACE",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "85242",
"telephone_number": "480-818-3069",
"fax_number": "480-895-9889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 E LAWNDALE PLACE",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "85242",
"telephone_number": "480-818-3069",
"fax_number": "480-895-9889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOB",
"first_name": "JENNIFER",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "OTA-L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "1313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.