Provider Demographics
NPI:1275731242
Name:OT 4 KIDZ, INC
Entity Type:Organization
Organization Name:OT 4 KIDZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, BCP
Authorized Official - Phone:310-344-2276
Mailing Address - Street 1:1932 14TH ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4605
Mailing Address - Country:US
Mailing Address - Phone:310-344-2276
Mailing Address - Fax:
Practice Address - Street 1:1932 14TH ST
Practice Address - Street 2:UNIT B
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-7028
Practice Address - Country:US
Practice Address - Phone:310-344-2276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2077OtherCALIFORNIA BOARD OF OCCUP
1022356OtherNATIONAL BOARD OF OCCUPAT