MEDICARE: THE KIDS OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1083561187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE KIDS OT

Provider Business Mailing Address
First Line	:	19730 VENTURA BLVD STE 103B
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2693
Country	:	US
Telephone Number	:	818-884-5362
Fax Number	:	818-884-5369

Provider Business Practice Location Address
First Line	:	19730 VENTURA BLVD STE 103B
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2693
Country	:	US
Telephone Number	:	818-884-5362
Fax Number	:	818-884-5369

Authorized Official
Title or Position	:	OWNER
Name	:	ALLA JARIABEK POURA POURA
Credential	:
Telephone Number	:	818-471-3344

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “THE KIDS OT ” Practice Location

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