Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY JEAN EVENSON
Active Sole ProprietorKELLY JEAN EVENSON is a Occupational Therapy Assistant healthcare provider located in LAKEPORT, California. NPI 1487264651 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · LAKEPORT, CA
Registration Details
- NPI Number
- 1487264651
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 3, 2020 (5.994946580796 yrs)
- Last Updated
- Aug 3, 2020
- License
-
4499 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1291 CRAIG AVELAKEPORT, CA, 954535704Browse CA providers · Browse ZIP 95453
- Phone
- 7072636382
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Other Occupational Therapy Assistant Providers in LAKEPORT, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. SHELLY LYNN FLANIGAN | COTA/L | 1598025710 |
| EVAN JOHN BETTEY | COTA/L | 1598279259 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.