Healthcare Provider Details

I. General information

NPI: 1912506791
Provider Name (Legal Business Name): KATHRYN MARIE FRABONI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 TESCONI CIR STE G
SANTA ROSA CA
95401-4611
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 707-544-2637
  • Fax:
Mailing address:
  • Phone: 282-588-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13668
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number323824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: