Provider Demographics
NPI:1154613040
Name:BEASON, KATHRYN ANN (OCCUPATIONAL THERAPY)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:BEASON
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2111 S EL CAMINO REAL
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-9000
Mailing Address - Country:US
Mailing Address - Phone:760-729-5433
Mailing Address - Fax:760-729-1764
Practice Address - Street 1:2111 S EL CAMINO REAL
Practice Address - Street 2:SUITE # 200
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-9000
Practice Address - Country:US
Practice Address - Phone:760-729-5433
Practice Address - Fax:760-729-1764
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist