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Individual

JENNESSA CHAN

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
Mailing address
4772 KATELLA AVE STE 100, LOS ALAMITOS, CA 90720-2681

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
18809
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18809
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
08/09/2018
Last updated
08/09/2018
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