MEDICARE: JANE JAMESETTA KUMAR OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	7282	CA

General Provider Information

NPI Number	:	1265690234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE JAMESETTA KUMAR OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 7771
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94537-7771
Country	:	US
Telephone Number	:	415-341-3468
Fax Number	:

Provider Business Practice Location Address
First Line	:	37010 DUSTERBERRY WAY UNIT 7771
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94537-6080
Country	:	US
Telephone Number	:	415-341-3468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/17/2015

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