Individual
KIMBERLY THACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
12900B GARDEN GROVE BLVD STE 235, GARDEN GROVE, CA 92843-2027
(714) 750-9700
(714) 750-9797
Mailing address
PO BOX 1726, WESTMINSTER, CA 92684-1726
(714) 750-9700
(714) 750-9797
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
OT22974
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2019
Last updated
03/28/2025
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