Healthcare Provider Details

I. General information

NPI: 1073243473
Provider Name (Legal Business Name): KARA MISAE THOMPSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 CORNERSTONE CT E STE 100
SAN DIEGO CA
92121-3724
US

IV. Provider business mailing address

9229 REGENTS RD UNIT L217
LA JOLLA CA
92037-9272
US

V. Phone/Fax

Practice location:
  • Phone: 858-304-6440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number23636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: