Provider Demographics
NPI:1770131864
Name:KANTOR, KATARINA FRANCES (OTR/L)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:FRANCES
Last Name:KANTOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2553 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-1645
Mailing Address - Country:US
Mailing Address - Phone:818-281-2106
Mailing Address - Fax:
Practice Address - Street 1:3025 HIGH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1807
Practice Address - Country:US
Practice Address - Phone:818-281-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist