Provider Demographics
| NPI: | 1801299615 |
|---|---|
| Name: | KIDSWORK, INC |
| Entity type: | Organization |
| Organization Name: | KIDSWORK, INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | KINA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | ALTEMOSE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 814-826-2652 |
| Mailing Address - Street 1: | 262 EL GRANADA BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HALF MOON BAY |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 94019-4853 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 814-862-2652 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 3401 MISSION ST |
| Practice Address - Street 2: | |
| Practice Address - City: | SAN FRANCISCO |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 94110-5419 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 415-695-1400 |
| Practice Address - Fax: | 415-695-1463 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-10-07 |
| Last Update Date: | 2014-10-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 152WV0400X | Eye and Vision Services Providers | Optometrist | Vision Therapy | Group - Multi-Specialty |
| No | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |