Healthcare Provider Details

I. General information

NPI: 1841013042
Provider Name (Legal Business Name): THE KIDS SPOT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 PULLMAN POINTE CT
HENDERSON NV
89012-4821
US

IV. Provider business mailing address

1405 PULLMAN POINTE CT
HENDERSON NV
89012-4821
US

V. Phone/Fax

Practice location:
  • Phone: 619-788-2615
  • Fax:
Mailing address:
  • Phone: 619-788-2615
  • Fax: 855-645-1415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: YAEL ESTERSOHN
Title or Position: OWNER
Credential:
Phone: 619-788-2615