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Individual

JEANETTE LOUISE SHATTUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
4772 KATELLA AVE STE 100, LOS ALAMITOS, CA 90720-2681
(562) 430-8700
(562) 430-8760
Mailing address
4772 KATELLA AVE STE 100, LOS ALAMITOS, CA 90720-2681
(562) 430-8700
(562) 430-8760

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
AA358119
CA
225X00000X
Occupational Therapist
AA358119
CA
225XE1200X
Ergonomics Occupational Therapist
AA358119
CA
225XH1200X
Hand Occupational Therapist
Primary
AA358119
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5481969
FIRST HEALTH ID
CA
01
OT0048180
BLUE SHIELD PIN
CA
Enumeration date
03/09/2007
Last updated
09/11/2025
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