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General NPI Number Information
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NPI Number | 1497344592
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Entity Type | Individual
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Provider Name | JENNA MILLER OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 4987 GOLDEN FOOTHILL PKWY
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9364
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Country | US
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Telephone | 916-365-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 JUNCTION BLVD APT 914
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City | ROSEVILLE
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State | CA
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Zip | 95747-4987
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Country | US
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Telephone | 916-220-9790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 513538
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License Number State | CA
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