Healthcare Provider Details

I. General information

NPI: 1083561187
Provider Name (Legal Business Name): THE KIDS OT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

19730 VENTURA BLVD STE 103B
WOODLAND HILLS CA
91364-2693
US

IV. Provider business mailing address

19730 VENTURA BLVD STE 103B
WOODLAND HILLS CA
91364-2693
US

V. Phone/Fax

Practice location:
  • Phone: 818-884-5362
  • Fax: 818-884-5369
Mailing address:
  • Phone: 818-884-5362
  • Fax: 818-884-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALLA JARIABEK POURA POURA
Title or Position: OWNER
Credential:
Phone: 818-471-3344