Kelley Kathryn O'Connor Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40661 Issued in CA

Practice address

1099 D St Ste 105
San Rafael, CA 94901-2839

Phone

(415) 532-8335

NPI assigned

Jul 13, 2010

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

• Kelley Kathryn O'Connor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 30)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Select Cal Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Palo Alto, CA
  • NPI 1053073643

  Physical Therapist

  NPD
• Select Cal Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Los Gatos, CA
  • NPI 1417619008

  Physical Therapist

  NPD
• Select Cal Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Morgan Hill, CA
  • NPI 1487317004

  Physical Therapist

  NPD
• Select Cal Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Rohnert Park, CA
  • NPI 1932875267
  NPD (past)
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1750693115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 FOREST AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012608",
            "telephone_number": "650-331-3700",
            "fax_number": "650-331-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 D ST STE 105",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012839",
            "telephone_number": "415-532-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KELLEY",
        "middle_name": "KATHRYN O'CONNOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017799",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "O'CONNOR",
            "middle_name": "KATHRYN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zoevina R Pariani-Delgado
• Kathryn Pariani, RD
• Alyssa Paris
• Linda Lee Parish
• Jongho Park
• Ann-Marie Karin Parker, MFT
• Mark Alden Parker
• Meka Angela Parks, RN
• Jennifer Benton Parlette, LMFT
• Mansi Parmar, PA

• Physical Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; 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.