Healthcare Provider Details

I. General information

NPI: 1851237358
Provider Name (Legal Business Name): JENNIFER BECK OTL, SWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEN BECK

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HERMAN AVE
WATSONVILLE CA
95076-2998
US

IV. Provider business mailing address

294 GREEN VALLEY RD
WATSONVILLE CA
95076-1300
US

V. Phone/Fax

Practice location:
  • Phone: 831-761-6617
  • Fax:
Mailing address:
  • Phone: 831-786-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number06425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: