Provider Demographics
NPI:1922605377
Name:LIVE & LEARN WELLNESS INSTITUTE LLC
Entity Type:Organization
Organization Name:LIVE & LEARN WELLNESS INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTRL
Authorized Official - Phone:415-726-7956
Mailing Address - Street 1:14102 MOORE CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1823
Mailing Address - Country:US
Mailing Address - Phone:415-726-7956
Mailing Address - Fax:
Practice Address - Street 1:14102 MOORE CT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-1823
Practice Address - Country:US
Practice Address - Phone:415-726-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty