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NPI Code Detail

MEDICARE: REDWOOD PEDIATRIC THERAPY ASSOCIATES INC

MEDICARE: REDWOOD PEDIATRIC THERAPY ASSOCIATES 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
1225XF0002XFeeding, Eating & Swallowing Occupational Therapist
2225XP0200XPediatric Occupational Therapist
32251P0200XPediatric Physical Therapist
4225100000XPhysical Therapist
5225X00000XOccupational Therapist

General Provider Information

NPI Number : 1669610085
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDWOOD PEDIATRIC THERAPY ASSOCIATES INC
Provider Business Mailing Address
First Line : 340 TESCONI CIR
Second Line : SUITE C
City : SANTA ROSA
State : CA
Zip : 95401-4676
Country : US
Telephone Number : 707-546-9160
Fax Number : 707-546-1338
Provider Business Practice Location Address
First Line : 340 TESCONI CIR
Second Line : SUITE C
City : SANTA ROSA
State : CA
Zip : 95401-4676
Country : US
Telephone Number : 707-546-9160
Fax Number : 707-546-1338
Authorized Official
Title or Position : PRESIDENT
Name : MS. KAREN SMITH
Credential : OTR/L
Telephone Number : 707-546-9160
Provider Enumeration Date : 01/22/2009
Last Update Date : 01/05/2017

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1497048979 — REDWOOD PEDIATRIC THERAPY ASSOCIATES INC
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SANTA ROSA, CA
95401-4676
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Practice Fax: 707-546-1338
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1992070247 — MS. CHLOE ANNE CONROY MS OTR/L
Practice Location Address:
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Practice Fax: 707-546-1338

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