Individual
JENNIFER WITTENAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
311 RAY ST, PLEASANTON, CA 94566-6621
(925) 399-5796
Mailing address
311 RAY ST, PLEASANTON, CA 94566-6621
(925) 399-5796
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
KY-R2392
KY
225XP0200X
Pediatric Occupational Therapist
Primary
KY-R2392
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1505
FIRST STEPS PROVIDER NUMB
KY
01
—
CA-19193
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY LICENSE
CA
Enumeration date
03/09/2007
Last updated
10/07/2021
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