Provider Demographics
NPI:1578818167
Name:SPRINGFIELD, KRISTIN (OT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SPRINGFIELD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 S ST STE 101-275
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-6736
Mailing Address - Country:US
Mailing Address - Phone:916-223-4936
Mailing Address - Fax:
Practice Address - Street 1:1680 E ROSEVILLE PKWY STE 112
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3988
Practice Address - Country:US
Practice Address - Phone:916-486-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7341225X00000X
UT10624940-4201225X00000X
NC4291225X00000X
VA0119001420225X00000X
CA20061225X00000X
SD1061225X00000X
IL56012343225X00000X
COOT.0005329225X00000X
IN31006525A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist