Kristen Nicole Imperial, MS OTR

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT17556 Issued in CA

Practice address

9191 Towne Centre Dr
San Diego, CA 92122-1225

Phone

(858) 554-3711

NPI assigned

Mar 17, 2015

Last updated

Aug 3, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1851784771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 TOWNE CENTRE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221225",
            "telephone_number": "858-554-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIAL",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "credential": "MS OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "46TR00647800",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT17556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imperial Valley Optometric Corporation (Carmel Mountain Vision Care Optometry)
• Imperial Valley Optometric Corporation (Optom-Eyes Vision Care)
• Imperial Valley Optometric Corporation (Sunglass and Optical Warehouse)
• Imperial Valley Optometric Corporation (Scripps Poway Eyecare & Optometry)
• Imperial Valley Optometric Corporation (Newport Avenue Optometry)
• Tamara Monet Imperial, AMFT
• Laura Rubin Imthurn, LCSW
• In Due Time Psychological Services, Inc
• In Stepps, Inc
• Emily In, MD

• Hand Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Hand Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.