Healthcare Provider Details

I. General information

NPI: 1881887768
Provider Name (Legal Business Name): JULIE KOCHENDERFER MA, OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 LAUREL CANYON BLVD STE 400
NORTH HOLLYWOOD CA
91606-1571
US

IV. Provider business mailing address

1530 N POINSETTIA PL APT 126
LOS ANGELES CA
90046-7926
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-0136
  • Fax: 818-763-3838
Mailing address:
  • Phone: 310-262-6810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 4865
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: