Kim Marie Atwater, OTR

Individual provider Active NPI Occupational Therapist · Carson, CA

NPI 1174724421 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1174724421
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
8599 (CA)
Practice address
1 Civic Plaza Dr
Suite 625
Carson, CA 90745-2243
Phone
(310) 549-4500
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Supplemental Health Care Past Accepting new patients
Supplemental Health Care Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8599 CA Yes

Addresses

Primary practice location

1 Civic Plaza Dr
Suite 625
Carson, CA 90745-2243

Mailing address

2549B Eastbluff Dr
#209
Newport Beach, CA 92660-3504
Phone (949) 241-5896

Other providers in Carson, CA

All providers in Carson, CA · Occupational Therapist in California

Sources for this page

Verify at the official NPI Registry.