Organization
PEDIATRIC THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERI LYNN ALLEN MOT, OTR/L (DIRECTOR OF SERVICES- OWNER)
(831) 684-1804
Entity
Organization
Contact information
Practice address
1940 BONITA DR. - UPSTAIRS, APTOS, CA 95003
(831) 684-1804
(831) 684-1826
Mailing address
1940 BONITA DR. - UPSTAIRS, APTOS, CA 95003
(831) 684-1804
(831) 684-1826
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT29813
CA
225XP0200X
Pediatric Occupational Therapist
Primary
OT2656
CA
225XP0200X
Pediatric Occupational Therapist
OT398
CA
225XP0200X
Pediatric Occupational Therapist
OT6062
CA
225XP0200X
Pediatric Occupational Therapist
OT7552
CA
235Z00000X
Speech-Language Pathologist
SP11200
CA
235Z00000X
Speech-Language Pathologist
SP12998
CA
235Z00000X
Speech-Language Pathologist
SP5343
CA
Other
Enumeration date
03/25/2007
Last updated
05/09/2019
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