Active NPI
Bonnie Lynn Kennedy, OTR/L, PHD
- Occupational Therapist
- South Pasadena, CA
National Provider Identifier
1154658110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 10863
- Practice address
- 822 Arroyo Dr
South Pasadena, CA 91030-2302 - Phone
- (626) 799-2795
- NPI assigned
- Nov 12, 2009
- Last updated
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 10863 | CA | Primary |
Addresses
Primary practice location
822 Arroyo Dr
South Pasadena, CA 91030-2302
Mailing address
822 Arroyo Dr
South Pasadena, CA 91030-2302
Phone (626) 799-2795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 10863 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1154658110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 ARROYO DR",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302302",
"telephone_number": "626-799-2795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 ARROYO DR",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302302",
"telephone_number": "626-799-2795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "BONNIE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "OTR/L, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT 10863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.