MEDICARE: KRISTINE SCALZO

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	225X00000X	Occupational Therapist		CA

General Provider Information

NPI Number	:	1164353421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE SCALZO

Provider Business Mailing Address
First Line	:	1170 REFUGIO ST
Second Line	:
City	:	GROVER BEACH
State	:	CA
Zip	:	93433-3245
Country	:	US
Telephone Number	:	805-458-9210
Fax Number	:

Provider Business Practice Location Address
First Line	:	602 ORCHARD AVE
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-4000
Country	:	US
Telephone Number	:	805-474-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ KRISTINE SCALZO ” Practice Location

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