Kelsey Bannan, MA, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

12038 Issued in CA

Practice address

1601 Eastman Ave
Suite 103
Ventura, CA 93003-6481

Phone

(805) 650-6912

NPI assigned

Jan 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelsey Peterson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1326438219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 EASTMAN AVE",
            "address_2": "SUITE 103",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 EASTMAN AVE",
            "address_2": "SUITE 103",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036481",
            "telephone_number": "805-650-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNAN",
        "first_name": "KELSEY",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "12038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "PETERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephan Leo Balitao
• Julia K Ballot
• Sophie Rae Banegas, MD
• Kenya S Banks
• Edward Jacob Banman, MD
• Ruth Bannatz, BSN,RN
• Stephanie Banuelos
• Audrey Zornizer Bar
• Valentina Barajas
• Baranski Chiropractic Incorporated

• Pediatric Occupational Therapist in Ventura, CA
• Providers in Ventura, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.