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General NPI Number Information
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NPI Number | 1225572787
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Entity Type | Organization
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Legal Business Name | CAPITAL KIDS OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 12/16/2016
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Last Update Date | 12/16/2016
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Provider Practice Location Address
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Address Line | 5270 ELVAS AVE
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City | SACRAMENTO
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State | CA
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Zip | 95819-2332
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Country | US
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Telephone | 916-296-4616
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Fax |
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Provider Business Mailing Address
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Address Line | 5716 FOLSOM BLVD #251
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City | SACRAMENTO
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State | CA
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Zip | 95819-4608
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Country | US
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Telephone | 916-296-4616
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLYN STALLINGS
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Credential | MOT, OTR/L
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Telephone | 916-296-4616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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