Provider Demographics
NPI:1225592132
Name:JENNIFER MORGAN PHYSICAL THERAPY
Entity type:Organization
Organization Name:JENNIFER MORGAN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, OTR/L
Authorized Official - Phone:310-456-0400
Mailing Address - Street 1:23823 MALIBU ROAD
Mailing Address - Street 2:SUITE 50, #242
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28990 PACIFIC COAST HWY STE 220
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-3944
Practice Address - Country:US
Practice Address - Phone:310-456-0400
Practice Address - Fax:310-919-0303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JENNIFER MORGAN PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty