Provider Demographics
NPI:1689902926
Name:HENNESSEY, CHRISTY WESTLUND (OTR)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:WESTLUND
Last Name:HENNESSEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 ADMIRAL CT
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-4757
Mailing Address - Country:US
Mailing Address - Phone:818-437-4080
Mailing Address - Fax:818-889-8878
Practice Address - Street 1:808 ADMIRAL CT
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-4757
Practice Address - Country:US
Practice Address - Phone:818-437-4080
Practice Address - Fax:818-889-8878
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT5989225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing