NPIMap

Organization Active NPI

Kid Fundamentals Therapy Center, Inc.

  • Pediatric Occupational Therapist
  • Garden Grove, CA
National Provider Identifier
1518529635
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
KID FUNDAMENTALS THERAPY CENTER, INC.
Practice address
12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027
Phone
(714) 750-9700
Fax
(714) 750-9797
NPI assigned
Jun 29, 2019
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Leslie C. Valmonte, M.A., OTR/LNPI 1770874299
Title
President
Phone
(714) 750-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

12900B Garden Grove Blvd Ste 235
Garden Grove, CA 92843-2027

Mailing address

PO Box 1726
Westminster, CA 92684-1726
Phone (714) 750-9700

Other identifiers 1

IdentifierTypeStateIssuer
1770874299OtherCANPI TYPE 1

National Provider Directory

National Provider Directory

Locations

12900A Garden Grove Blvd
Ste 220
Garden Grove, CA 92843

12900B Garden Grove Blvd
Ste 235
Garden Grove, CA 92843
Phone (714) 750-9700

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1561766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1518529635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1726",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926841726",
            "telephone_number": "714-750-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900B GARDEN GROVE BLVD STE 235",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432027",
            "telephone_number": "714-750-9700",
            "fax_number": "714-750-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID FUNDAMENTALS THERAPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-29",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "VALMONTE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-750-9700",
        "authorized_official_credential": "M.A., OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1770874299",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.