Healthcare Provider Details

I. General information

NPI: 1649181587
Provider Name (Legal Business Name): JENNIFER ANDERSON MA, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 SCOTT RD
BURBANK CA
91504-1736
US

IV. Provider business mailing address

1526 HAZELWOOD AVE
LOS ANGELES CA
90041-3316
US

V. Phone/Fax

Practice location:
  • Phone: 818-729-1650
  • Fax:
Mailing address:
  • Phone: 818-645-4807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3960
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: