Provider Demographics
NPI:1770818411
Name:ZANDER, JOANN (OTR)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:ZANDER
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:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1051 LAS TABLAS RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-5603
Practice Address - Country:US
Practice Address - Phone:805-434-4885
Practice Address - Fax:805-434-2864
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4011-026225X00000X
GAOT005541225X00000X
FLOT18054225X00000X
VA0119009177225X00000X
CA18357225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEZABFOtherFL BCBS
GA003140351CMedicaid