Provider Demographics
NPI:1144623265
Name:BULMANSKI, JENNIFER KAY (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KAY
Last Name:BULMANSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KAY
Other - Last Name:KAUTZKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1949 AVENIDA DEL ORO
Mailing Address - Street 2:STE 118
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5829
Mailing Address - Country:US
Mailing Address - Phone:760-945-6500
Mailing Address - Fax:
Practice Address - Street 1:1949 AVENIDA DEL ORO
Practice Address - Street 2:STE 118
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5829
Practice Address - Country:US
Practice Address - Phone:760-945-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14714225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist