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General NPI Number Information
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NPI Number | 1922811918
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Entity Type | Organization
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Legal Business Name | PLAYFUL STRIDES
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 114 QUAIL HOLLOW RD
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City | FELTON
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State | CA
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Zip | 95018-9452
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Country | US
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Telephone | 831-216-8591
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Fax | 831-480-5841
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Provider Business Mailing Address
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Address Line | PO BOX 344
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City | MOUNT HERMON
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State | CA
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Zip | 95041-0344
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Country | US
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Telephone | 831-216-8591
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Fax | 831-480-5841
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST, OWNER
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Name | REGAN CLEMENTI
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Credential | OTR/L
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Telephone | 831-216-8591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 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 #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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