Healthcare Provider Details

I. General information

NPI: 1518333798
Provider Name (Legal Business Name): NATALEE KAMAU DPT, MS, OTR/L, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11838 BERNARDO PLAZA CT #110
SAN DIEGO CA
92128-2413
US

IV. Provider business mailing address

11838 BERNARDO PLAZA CT #110
SAN DIEGO CA
92128-2413
US

V. Phone/Fax

Practice location:
  • Phone: 858-673-5437
  • Fax: 858-673-5434
Mailing address:
  • Phone: 858-673-5437
  • Fax: 858-673-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number43296
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number14143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: