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General NPI Number Information
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NPI Number | 1982488565
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Entity Type | Organization
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Legal Business Name | OUTDOOR KIDS OCCUPATIONAL THERAPY, INC.
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 3300 JOAQUIN MILLER RD
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City | OAKLAND
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State | CA
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Zip | 94602
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Country | US
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Telephone | 510-431-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 DOMINGO AVE # 1092
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City | BERKELEY
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State | CA
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Zip | 94705-2454
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Country | US
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Telephone | 510-431-8114
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LAURA FIGUEROA
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Credential | PHD, OTR/L
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Telephone | 510-289-5332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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