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General NPI Number Information
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NPI Number | 1588539365
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Entity Type | Organization
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Legal Business Name | OPEN GROUNDS INC.
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 234 S PACIFIC COAST HWY STE 205
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City | REDONDO BEACH
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State | CA
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Zip | 90277-7036
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Country | US
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Telephone | 310-882-0177
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Fax |
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Provider Business Mailing Address
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Address Line | 234 S PACIFIC COAST HWY STE 205
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City | REDONDO BEACH
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State | CA
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Zip | 90277-7036
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Country | US
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Telephone | 310-882-0177
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHAUNNA KOTKA
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Credential | OTD, OTR/L, CLT-LANA
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Telephone | 310-882-0177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational 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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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