Individual provider Active NPI

Jennifer Lynn Davis, MS, OTR/L, SCFES, SW

  • Pediatric Occupational Therapist
  • San Jose, CA
National Provider Identifier
1609110063
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
11766 Issued in CA
Practice address
2262 N 1St St
San Jose, CA 95131-2022
Phone
(408) 337-2727
Fax
(408) 478-4130
NPI assigned
Nov 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X 11766 CA
Mental Health Occupational Therapist 225XM0800X 11766 CA
Pediatric Occupational Therapist 225XP0200X 11766 CA Primary

Addresses

Primary practice location

2262 N 1St St
San Jose, CA 95131-2022

Mailing address

2262 N 1St St
San Jose, CA 95131-2022
Phone (408) 337-2727

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joy and Laughter Developmental Therapy Current Accepting new patients
JLD Therapy, PC CurrentSince Jul 31, 2022 Accepting new patients
JLD All-Stars Feeding, Eating & Swallowing Current Accepting new patients
Joy & Laughter Developmental Therapy PastSince Jul 31, 2022 Accepting new patients

Locations

2262 N 1st St
San Jose, CA 95131
Phone (408) 337-2727

826 N Winchester Blvd
Ste 2G
San Jose, CA 95128
Phone (408) 337-2727

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1609110063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2262 N 1ST ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312022",
            "telephone_number": "408-337-2727",
            "fax_number": "408-478-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 N 1ST ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312022",
            "telephone_number": "408-337-2727",
            "fax_number": "408-478-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MS, OTR/L, SCFES, SW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "CA",
            "license": "11766",
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "CA",
            "license": "11766",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "11766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.