MEDICARE: OPEN GROUNDS INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225XM0800X	Mental Health Occupational Therapist
2	225XN1300X	Neurorehabilitation Occupational Therapist
3	225XP0019X	Physical Rehabilitation Occupational Therapist

General Provider Information

NPI Number	:	1588539365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN GROUNDS INC.

Provider Business Mailing Address
First Line	:	234 S PACIFIC COAST HWY STE 205
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-7036
Country	:	US
Telephone Number	:	310-437-0932
Fax Number	:	844-688-0141

Provider Business Practice Location Address
First Line	:	234 S PACIFIC COAST HWY STE 205
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-7036
Country	:	US
Telephone Number	:	310-437-0932
Fax Number	:	844-688-0141

Authorized Official
Title or Position	:	CEO
Name	:	MRS. SHAUNNA KOTKA
Credential	:	OTD, OTR/L, CLT-LANA
Telephone Number	:	310-437-0932

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	05/26/2026

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Directions to “OPEN GROUNDS INC. ” Practice Location

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