MEDICARE: KIDZSPOT PEDIATRIC THERAPY-EAST VALLEY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	2251P0200X	Pediatric Physical Therapist
3	225XP0200X	Pediatric Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588720825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDZSPOT PEDIATRIC THERAPY-EAST VALLEY

Provider Business Mailing Address
First Line	:	4838 E BASELINE RD STE 112
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4674
Country	:	US
Telephone Number	:	480-900-6572
Fax Number	:

Provider Business Practice Location Address
First Line	:	4838 E BASELINE RD STE 112
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4674
Country	:	US
Telephone Number	:	480-900-6572
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BETHANY WARKENTIN
Credential	:
Telephone Number	:	480-900-6572

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	10/24/2025

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Directions to “KIDZSPOT PEDIATRIC THERAPY-EAST VALLEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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