Active NPI
Jetta Colleen Herring, COTA
- Occupational Therapy Assistant
- Bakersfield, CA
National Provider Identifier
1841526589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA1704
- Practice address
- 11508 Darlington Ave
Bakersfield, CA 93312-6472 - Phone
- (661) 679-4456
- NPI assigned
- Nov 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | OTA1704 | CA | Primary |
Addresses
Primary practice location
11508 Darlington Ave
Bakersfield, CA 93312-6472
Mailing address
11508 Darlington Ave
Bakersfield, CA 93312-6472
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA 1704 | Other | CA | CALIFORNIA BOARD OF OCCUPATIONAL THERAPY |
| 235417 | Other | MD | NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY, INC. |
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 |
|---|---|---|---|
| OTA1704 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257033600000",
"number": "1841526589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11508 DARLINGTON AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933126472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11508 DARLINGTON AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933126472",
"telephone_number": "661-679-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRING",
"first_name": "JETTA",
"middle_name": "COLLEEN",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-01",
"last_updated": "2009-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "OTA1704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY",
"identifier": "OTA 1704",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY, INC.",
"identifier": "235417",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.