Provider Demographics
NPI:1922267772
Name:KALMANSON, KIMBERLY REA (MA, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:REA
Last Name:KALMANSON
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 20TH ST
Mailing Address - Street 2:CFDC
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2033
Mailing Address - Country:US
Mailing Address - Phone:310-582-7468
Mailing Address - Fax:
Practice Address - Street 1:1339 20TH ST
Practice Address - Street 2:CFDC
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2033
Practice Address - Country:US
Practice Address - Phone:310-582-7468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 4170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist