Healthcare Provider Details

I. General information

NPI: 1225062375
Provider Name (Legal Business Name): KATHLEEN PAISLEY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 IMPERIAL HWY STE C
DOWNEY CA
90242-3464
US

IV. Provider business mailing address

24 HAMMOND STE C
IRVINE CA
92618-1680
US

V. Phone/Fax

Practice location:
  • Phone: 562-869-7786
  • Fax:
Mailing address:
  • Phone: 949-770-6022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: