Individual
MISS JENNIFER BETH ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1932 14TH ST, SANTA MONICA, CA 90404-4605
(310) 344-2276
Mailing address
1932 14TH ST, SANTA MONICA, CA 90404-4605
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
711
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
711
CA BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
06/18/2017
Last updated
06/18/2017
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