JEANETTE LOUISE SHATTUCK OTR L NPI 1003948928

NPI Information

NPI: 1003948928
Provider Name: JEANETTE LOUISE SHATTUCK, OTR L
Classification: Orthotic Fitter - 225000000X
Entity Type: Individual
Address:
4772 KATELLA AVE STE 100
LOS ALAMITOS, CA
ZIP 90720
Phone: (562) 430-8700
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Jeanette Louise Shattuck, OTR L is an orthotic fitter in Los Alamitos, CA. The provider is an individual trained in the management of fitting prefabricated orthoses. Jeanette Louise Shattuck, OTR L NPI is 1003948928. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4772 KATELLA AVE STE 100
LOS ALAMITOS, CA
ZIP 90720-681
Phone: (562) 430-8700
Fax: (562) 430-8760

The enumeration date for this NPI number is 3/9/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225000000X	Orthotic Fitter		AA358119	CALIFORNIA	Yes
2	225X00000X	Occupational Therapist		AA358119	CALIFORNIA	X
3	225XE1200X	Occupational Therapist	Ergonomics	AA358119	CALIFORNIA	X
4	225XH1200X	Occupational Therapist	Hand	AA358119	CALIFORNIA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5481969	OTHER	CALIFORNIA	FIRST HEALTH ID
2	WOT4818A	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE PPIN
3	OT0048180	OTHER	CALIFORNIA	BLUE SHIELD PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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