Provider Demographics
NPI:1073951380
Name:HEMINGWAY, VANESSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 N BRANCIFORTE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-1050
Mailing Address - Country:US
Mailing Address - Phone:831-515-2945
Mailing Address - Fax:
Practice Address - Street 1:737 N BRANCIFORTE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1050
Practice Address - Country:US
Practice Address - Phone:831-705-3014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-08
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11645225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist