Jennifer Mitchell, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12743 Issued in CA

Practice address

954 Camino de la Reina Unit 95
San Diego, CA 92108-3245

Phone

(619) 850-5975

NPI assigned

Jul 19, 2023

Last updated

Jul 19, 2023By 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 names 1

• Jennifer Runkle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1851071559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 CAMINO DE LA REINA UNIT 95",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083245",
            "telephone_number": "619-850-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 CAMINO DE LA REINA UNIT 95",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083245",
            "telephone_number": "619-850-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JENNIFER",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RUNKLE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Mitchell, LCSW
• Forest Mitchell
• Hope Deanna Mitchell
• Jason Kristopher Mitchell, IDC
• Jennie L Mitchell, CADC-1
• Jennifer Lynn Mitchell
• Jenny Emmaline Mitchell, PHD
• Jesyka Lee Mitchell, PTA
• Jillian Mitchell, PT
• Karen Elizabeth Mitchell, MSN, RN

• Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.