Provider Demographics
NPI:1518233246
Name:LOWRY, JENNA LYNNE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNNE
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RYAN INDUSTRIAL CT STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1772
Mailing Address - Country:US
Mailing Address - Phone:925-855-9810
Mailing Address - Fax:925-263-1906
Practice Address - Street 1:125 RYAN INDUSTRIAL CT STE 205
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1772
Practice Address - Country:US
Practice Address - Phone:925-855-9810
Practice Address - Fax:925-263-1906
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11877225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics