Healthcare Provider Details

I. General information

NPI: 1770091472
Provider Name (Legal Business Name): JEAN WEITENSTEINER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4462 FOOTHILL RD
CARPINTERIA CA
93013-3075
US

IV. Provider business mailing address

PO BOX 23945
SANTA BARBARA CA
93121-3945
US

V. Phone/Fax

Practice location:
  • Phone: 805-698-7581
  • Fax:
Mailing address:
  • Phone: 805-563-2669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number4310
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number4310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: