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NPI Code Detail

MEDICARE: KIDS FIRST PEDIATRIC THERAPY, INC.

MEDICARE: KIDS FIRST PEDIATRIC THERAPY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist7262CA
2225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1053815878
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS FIRST PEDIATRIC THERAPY, INC.
Provider Business Mailing Address
First Line : 6833 KENTON PL
Second Line :
City : EASTVALE
State : CA
Zip : 92880-3789
Country : US
Telephone Number : 626-780-5944
Fax Number :
Provider Business Practice Location Address
First Line : 101 SPRING ST
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4930
Country : US
Telephone Number : 626-780-5944
Fax Number :
Authorized Official
Title or Position : DIRECTOR/OWNER
Name : STEPHANIE NICOLE MARTINEZ
Credential : OTR/L
Telephone Number : 626-780-5944
Provider Enumeration Date : 03/19/2018
Last Update Date : 07/20/2021

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Directions to “KIDS FIRST PEDIATRIC THERAPY, INC. ” Practice Location

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