Connected Kids Pediatric Therapy, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

CONNECTED KIDS PEDIATRIC THERAPY, LLC

Practice address

20588 S Ellsworth Loop Rd Apt 3125
Queen Creek, AZ 85142-0146

Phone

(602) 341-3770

Fax

(602) 560-0504

NPI assigned

Feb 16, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jaclyn Pastena, OTD, OTR/LNPI 1922616374

Title

Occupational Therapist

Phone

(023) 413-7706

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Pastena, OTR/L

  • Occupational Therapist
  • Queen Creek, AZ
  • NPI 1922616374
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1043918378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20588 S ELLSWORTH LOOP RD APT 3125",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851420146",
            "telephone_number": "602-341-3770",
            "fax_number": "602-560-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20588 S ELLSWORTH LOOP RD APT 3125",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851420146",
            "telephone_number": "602-341-3770",
            "fax_number": "602-560-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTED KIDS PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "PASTENA",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "023-413-7706",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.