Organization
KID FUNDAMENTALS THERAPY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE C. VALMONTE M.A., OTR/L (PRESIDENT)
(714) 750-9700
Entity
Organization
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
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770874299
NPI TYPE 1
CA
Enumeration date
06/29/2019
Last updated
11/22/2021
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