Active NPI
Kids Therapy 4 Success
- Pediatric Occupational Therapist
- Lodi, CA
National Provider Identifier
1740871698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Legal business name
- KIDS THERAPY 4 SUCCESS
- Practice address
- 118 N Church St
Lodi, CA 95240-2103 - Phone
- (209) 443-4244
- NPI assigned
- Feb 2, 2021
- Organization subpart
- Yes
- Parent organization
- LODI CHILDREN'S THERAPY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shelley Banks, OTR/L
- Title
- Occupational Therpist/Partner
- Phone
- (209) 327-3309
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | |||
| Physical Therapy Assistant | 225200000X | |||
| Pediatric Occupational Therapist | 225XP0200X | Primary |
Addresses
Primary practice location
118 N Church St
Lodi, CA 95240-2103
Mailing address
PO Box 621
Woodbridge, CA 95258-0621
Phone (209) 327-3309
Other names 1
- Lodi Children's Therapy
National Provider Directory
National Provider Directory- Part of
- Kids Therapy 4 Success
Locations
118 N Church St
Lodi, CA 95240
Phone (209) 443-4244
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612224000000",
"number": "1740871698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 621",
"city": "WOODBRIDGE",
"state": "CA",
"postal_code": "952580621",
"telephone_number": "209-327-3309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 N CHURCH ST",
"city": "LODI",
"state": "CA",
"postal_code": "952402103",
"telephone_number": "209-443-4244"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIDS THERAPY 4 SUCCESS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LODI CHILDREN'S THERAPY",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A",
"authorized_official_last_name": "BANKS",
"authorized_official_first_name": "SHELLEY",
"authorized_official_title_or_position": "OCCUPATIONAL THERPIST/PARTNER",
"authorized_official_telephone_number": "209-327-3309",
"authorized_official_credential": "OTR/L"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lodi Children's Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.