Jenna Matteson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

7375 Issued in AZ

Practice address

1950 E Lafayette Ave
Gilbert, AZ 85298-0821

Phone

(480) 274-3951

NPI assigned

Feb 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Michael Allen Douglas & Kimberli C Douglas Bounce Back Speech Therapy

  • Home Health Agency
  • Gilbert, AZ
  • NPI 1881894202
  NPD (past)

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1841791779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 E LAFAYETTE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E LAFAYETTE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980821",
            "telephone_number": "480-274-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "JENNA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "7375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Salvatore Matiella, M.ED, BCBA
• Matier Industries Inc
• Rebecca Anne Matsumori, RN
• Emily Virginia Matta
• Danielle Matter
• Brittany Michelle Matthews
• John Reza Matthews, M.D.
• Karena Matthews
• Tara A Mattingly, DMD
• Faith Mattson

• Occupational Therapy Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.