Provider Demographics
NPI:1427124668
Name:HURLEY, JENNIFER LYNN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:HURLEY
Suffix:
Gender:F
Credentials: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:PO BOX 28647
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95159-8647
Mailing Address - Country:US
Mailing Address - Phone:310-948-4946
Mailing Address - Fax:408-286-0991
Practice Address - Street 1:112 S MORRISON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3021
Practice Address - Country:US
Practice Address - Phone:310-948-4946
Practice Address - Fax:408-286-0991
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7954225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist