Healthcare Provider Details

I. General information

NPI: 1477470698
Provider Name (Legal Business Name): JENNIPHER HANRATTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIPHER HANRATTY RAJA

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33122 VALLE RD
SAN JUAN CAPISTRANO CA
92675-4853
US

IV. Provider business mailing address

33122 VALLE RD
SAN JUAN CAPISTRANO CA
92675-4853
US

V. Phone/Fax

Practice location:
  • Phone: 949-697-2579
  • Fax:
Mailing address:
  • Phone: 494-697-2579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: