MEDICARE: KATHLEEN LEMOS OTR/L

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
1	225X00000X	Occupational Therapist	1533	CA

General Provider Information

NPI Number	:	1962331538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN LEMOS OTR/L

Provider Business Mailing Address
First Line	:	1242 DIAMOND BAR CT
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96003-2194
Country	:	US
Telephone Number	:	530-515-4712
Fax Number	:

Provider Business Practice Location Address
First Line	:	4620 VALLECITO ST
Second Line	:
City	:	SHASTA LAKE
State	:	CA
Zip	:	96019-9348
Country	:	US
Telephone Number	:	530-275-7020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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