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NPI Code Detail

MEDICARE: JENNA MANGIAGLI

MEDICARE: JENNA MANGIAGLI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1972257657
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA MANGIAGLI
Provider Business Mailing Address
First Line : 2007 CIRCLE DR
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-2838
Country : US
Telephone Number : 310-614-7187
Fax Number :
Provider Business Practice Location Address
First Line : 11460 W WASHINGTON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-6030
Country : US
Telephone Number : 310-337-7115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2022
Last Update Date : 02/10/2022

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Directions to “ JENNA MANGIAGLI ” Practice Location

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