Provider Demographics
NPI:1679606123
Name:LERNER, JOAN E (OTR - L)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:LERNER
Suffix:
Gender:F
Credentials:OTR - L
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:ELIZABETH
Other - Last Name:LERNER-DURHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR - L
Mailing Address - Street 1:608 BUTTON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2223
Mailing Address - Country:US
Mailing Address - Phone:831-429-6348
Mailing Address - Fax:831-429-6348
Practice Address - Street 1:608 BUTTON ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2223
Practice Address - Country:US
Practice Address - Phone:831-429-6348
Practice Address - Fax:831-429-6348
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT3411225XN1300X
CAOT 3411225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics