Provider Demographics
NPI:1336659986
Name:HANDWERGER, JESSICA SARAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SARAH
Last Name:HANDWERGER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:S
Other - Last Name:LIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:18240 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3602
Mailing Address - Country:US
Mailing Address - Phone:818-521-4723
Mailing Address - Fax:
Practice Address - Street 1:15643 SHERMAN WAY STE 300
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4177
Practice Address - Country:US
Practice Address - Phone:818-788-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist