Healthcare Provider Details

I. General information

NPI: 1891630091
Provider Name (Legal Business Name): JENNIFER NEWMAN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 UNION ST
OAKLAND CA
94607-2236
US

IV. Provider business mailing address

570 PAGE ST APT 2
SAN FRANCISCO CA
94117-3454
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-8000
  • Fax:
Mailing address:
  • Phone: 717-419-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number19686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: