Provider Demographics
NPI:1306234745
Name:HIER, JENNIFER MEGAN (COTA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MEGAN
Last Name:HIER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 TEMPLETON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-2269
Mailing Address - Country:US
Mailing Address - Phone:909-763-9521
Mailing Address - Fax:
Practice Address - Street 1:5137 TEMPLETON ST APT 7
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-2269
Practice Address - Country:US
Practice Address - Phone:909-763-9521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2915224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant