Healthcare Provider Details

I. General information

NPI: 1447569298
Provider Name (Legal Business Name): JENNIFER LAUR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 DE LA VINA ST SUITE 106
SANTA BARBARA CA
93105-3877
US

IV. Provider business mailing address

2925 PASEO DEL REFUGIO
SANTA BARBARA CA
93105-2929
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-3055
  • Fax:
Mailing address:
  • Phone: 415-233-0421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number11761
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number11761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: