Jennessa Chan, OTR/L

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

18809 Issued in CA

Practice address

4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681

Phone

(562) 430-8700

NPI assigned

Aug 9, 2018

Last updated

Aug 9, 2018By the provider in NPPES

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

Interoperability endpoints

• Direct secure messaging: jennessa.chan.p29@direct.newportmed.nextgenshare.com

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

• Shattuck Rehabilitation Services

  dba Healing Hands Therapy & Wellness Center

  • Hand Occupational Therapist
  • Los Alamitos, CA
  • NPI 1245361591
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1720567860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 KATELLA AVE STE 100",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 KATELLA AVE STE 100",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202681",
            "telephone_number": "562-430-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JENNESSA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "18809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "18809",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centers for Family Medicine GP (Optumcare Medical Group)
• Cep America-California
• Alexa Y Chai, M.D.
• Stuart Alexander Chalfin, M.D.
• Daniel Nora Chan, MD
• Jesse L. Chang, M.D.
• Russell Ek Chang, DDS MS FACD
• Suna Huynh Chang, FNP
• Cynthia W Chao, DO A PROFESSIONAL CO
• Charles M Maples

• Hand Occupational Therapist in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Hand Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.