Active NPI
Kathy Kolden Kelley, RTC
- Recreation Therapist
- Livermore, CA
National Provider Identifier
1669480794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 2580-T
- Practice address
- 4951 Arroyo Rd
Livermore, CA 94550-9650 - Phone
- (925) 373-4700
- Fax
- (925) 449-6415
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 2580-T | CA | Primary |
Addresses
Primary practice location
4951 Arroyo Rd
Livermore, CA 94550-9650
Mailing address
1796 Oro Dr
Fremont, CA 94539-3687
Phone (925) 373-4700
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2580-T | CA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669480794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1796 ORO DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945393687",
"telephone_number": "925-373-4700",
"fax_number": "925-449-6415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4951 ARROYO RD",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945509650",
"telephone_number": "925-373-4700",
"fax_number": "925-449-6415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "KATHY",
"middle_name": "KOLDEN",
"name_prefix": "Ms.",
"credential": "RTC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "CA",
"license": "2580-T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.