NPI 1942629654

Kelly Staveley, COTA

Practitioner Occupational Therapy Assistant Costa Mesa, CA

Practice location

Address: 1700 Adams Ave Suite 103, Costa Mesa, CA 92626-4865
Phone: (714) 556-2288
Fax: (714) 435-1745
Mailing address: 1700 Adams Ave Suite 103, Costa Mesa, CA 92626

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence CA 1850 (CA)

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Registry record

NPI: 1942629654
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Apr 2014
Record last updated: 9 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.