Provider Demographics
NPI:1558185272
Name:ATCHISON, KRISTY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 KATHY LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9213
Mailing Address - Country:US
Mailing Address - Phone:530-966-5203
Mailing Address - Fax:
Practice Address - Street 1:2100 DR MARTIN LUTHER KING JUNIOR PKWY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4422
Practice Address - Country:US
Practice Address - Phone:530-332-1742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist