Provider Demographics
NPI:1205691714
Name:NEW DIRECTIONS FOR KIDS
Entity type:Organization
Organization Name:NEW DIRECTIONS FOR KIDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:RUTSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:805-474-6811
Mailing Address - Street 1:191 S OAK PARK BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2265
Mailing Address - Country:US
Mailing Address - Phone:805-474-6811
Mailing Address - Fax:805-668-2290
Practice Address - Street 1:191 S OAK PARK BLVD STE 9
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2265
Practice Address - Country:US
Practice Address - Phone:805-474-6811
Practice Address - Fax:805-668-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty