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General NPI Number Information
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NPI Number | 1750056750
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Entity Type | Individual
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Provider Name | KRISTIE DEVRIES OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 235 NUTMEG ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-6201
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Country | US
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Telephone | 619-239-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 33591 DANA VISTA DR UNIT D
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City | DANA POINT
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State | CA
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Zip | 92629-1739
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Country | US
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Telephone | 949-426-0000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 22695
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License Number State | CA
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