Active NPI
Andrea Nicole Kjelstrom, MS, OTR/L
- Pediatric Occupational Therapist
- Concord, CA
National Provider Identifier
1346935889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 12268
- Practice address
- 1200 Concord Ave Ste 100
Concord, CA 94520-4969 - Phone
- (888) 839-6101
- NPI assigned
- Apr 10, 2023
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 12268 | CA | Primary |
Addresses
Primary practice location
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Mailing address
3660 William Way
Sacramento, CA 95821-3136
Phone (916) 425-2419
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12268 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681171200000",
"number": "1346935889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3660 WILLIAM WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958213136",
"telephone_number": "916-425-2419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CONCORD AVE STE 100",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204969",
"telephone_number": "888-839-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KJELSTROM",
"first_name": "ANDREA",
"middle_name": "NICOLE",
"name_prefix": "Prof.",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-11",
"certification_date": "2023-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "12268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.