Jessica Clemente, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT16168 Issued in CA

Practice address

21641 Canada Rd Apt 8K
Lake Forest, CA 92630-2765

Phone

(949) 257-2213

NPI assigned

Apr 9, 2016

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

Other names 1

• Jessica Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1992169510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21641 CANADA RD APT 8K",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302765",
            "telephone_number": "949-257-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21641 CANADA RD APT 8K",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302765",
            "telephone_number": "949-257-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 E Beverly Blvd",
            "address_purpose": "LOCATION",
            "city": "Montebello",
            "state": "CA",
            "postal_code": "906403775",
            "country_code": "US",
            "telephone_number": "323-724-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31405 Taylor Ln",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925922816",
            "country_code": "US",
            "telephone_number": "951-293-0355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "JESSICA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monica Cisneros
• Stacy Clark, LMFT
• Julie Ann Claveria, M.D.
• Nicole Ann Clelland
• Bailey Clement, MS CF-SLP
• Coast Medical Service & Supplies Inc
• Coastline Endocrinology Associates, P.C.
• Stephanie Coe
• Patricia Jackson Colando, MS CCCSLP
• Kaleen Pearl Cole

• Occupational Therapist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.