Provider Demographics
NPI:1063735470
Name:BELANGER, KATHRIN ANNE (OTR/L, CHT)
Entity type:Individual
Prefix:MS
First Name:KATHRIN
Middle Name:ANNE
Last Name:BELANGER
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:MRS
Other - First Name:KATHRIN
Other - Middle Name:ANNE
Other - Last Name:MCFARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:16899 W BERNARDO DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1603
Mailing Address - Country:US
Mailing Address - Phone:858-521-2265
Mailing Address - Fax:858-521-2016
Practice Address - Street 1:16899 W BERNARDO DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1603
Practice Address - Country:US
Practice Address - Phone:858-521-2265
Practice Address - Fax:858-521-2016
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 10524225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA201111050OtherCERTIFIED HAND THERAPIST
PTAN E0519ZOtherMEDICARE NON-PHYSICIAN PTAN