Provider Demographics
NPI:1497229181
Name:LINDSEY, JESSICA LEANN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LEANN
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LEANN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2449 COURT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2525
Mailing Address - Country:US
Mailing Address - Phone:530-224-7686
Mailing Address - Fax:530-224-9581
Practice Address - Street 1:2449 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2525
Practice Address - Country:US
Practice Address - Phone:530-224-7686
Practice Address - Fax:530-224-9581
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4517224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant