Provider Demographics
NPI:1144574583
Name:MENDIOLA, JENNA NICOLE (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:NICOLE
Last Name:MENDIOLA
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:NICOLE
Other - Last Name:NEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:14190 ORCHARD PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9708
Mailing Address - Country:US
Mailing Address - Phone:720-497-6666
Mailing Address - Fax:720-497-6777
Practice Address - Street 1:14190 ORCHARD PKWY STE 250
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9708
Practice Address - Country:US
Practice Address - Phone:720-497-6666
Practice Address - Fax:720-497-6777
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06375225X00000X
CA16599225X00000X
CO7212225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist