Healthcare Provider Details

I. General information

NPI: 1225592132
Provider Name (Legal Business Name): JENNIFER MORGAN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28990 PACIFIC COAST HWY STE 220
MALIBU CA
90265-3944
US

IV. Provider business mailing address

23823 MALIBU ROAD SUITE 50, #242
MALIBU CA
90265
US

V. Phone/Fax

Practice location:
  • Phone: 310-456-0400
  • Fax: 310-919-0303
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER LYNN MORGAN
Title or Position: OWNER & OCCUPATIONAL THERAPIST
Credential: MA, OTR/L
Phone: 310-456-0400