Provider Demographics
NPI:1114630829
Name:BARRERA, JESSICA ROCHELLE (DOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROCHELLE
Last Name:BARRERA
Suffix:
Gender:F
Credentials:DOT, 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:PO BOX 17411
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-0411
Mailing Address - Country:US
Mailing Address - Phone:210-390-1795
Mailing Address - Fax:855-702-2527
Practice Address - Street 1:327 W SUNSET RD APT 1303
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1703
Practice Address - Country:US
Practice Address - Phone:210-390-1795
Practice Address - Fax:855-702-2527
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122966225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist