Provider Demographics
NPI:1437547551
Name:PLAY2GROW PEDIATRIC THERAPY, INC.
Entity Type:Organization
Organization Name:PLAY2GROW PEDIATRIC THERAPY, INC.
Other - Org Name:PLAY2GROW PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L, SWC
Authorized Official - Phone:916-834-4379
Mailing Address - Street 1:5714 FOLSOM BLVD
Mailing Address - Street 2:PLAY2GROW PEDIATRIC THERAPY #297
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-4608
Mailing Address - Country:US
Mailing Address - Phone:916-834-4379
Mailing Address - Fax:
Practice Address - Street 1:6768 9TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2106
Practice Address - Country:US
Practice Address - Phone:916-834-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7936225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty