KELLEY KATHRYN O'CONNOR PARK (NPI# 1750693115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750693115 |
| Entity Type | Individual |
| Full Name | KELLEY KATHRYN O'CONNOR PARK |
| Other Name | KELLEY KATHRYN O'CONNOR |
| Credential | DPT |
| Practice Address |
1099 D St Ste 105 San Rafael CA 94901-2839 |
| Mailing Address |
454 Forest Ave Palo Alto CA 94301-2608 |
| Practice Telephone | 4155328335 |
| Mailing Telephone | 6503313700 |
| Mailing Fax Number | 6503313730 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2020-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 40661 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225100000X | Physical Therapist | 070017799 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265067318 | Kelley Park | Student in an Organized Health Care Education/Training Program | 540 E Canfield St, Detroit, MI 48201-1928 | 2020-03-10 |
| Street Address |
1099 D ST STE 105 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-2839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203071 | Alex Ung | Physical Therapist | 1099 D St Ste 105, San Rafael, CA 94901-2839 | 2020-10-20 |
| 1417593294 | Tricia Rose Serres | Physical Therapist | 1099 D St Ste 105, San Rafael, CA 94901-2839 | 2019-11-26 |
| 1336528645 | Kate Anne Rappa | Physical Therapy Assistant | 1099 D St Ste 105, San Rafael, CA 94901-2839 | 2015-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205329125 | Shirley Rombouts Taylor | Physical Therapist | 80 Creekside Dr, San Rafael, CA 94903-1055 | 2018-06-14 |
| 1588172878 | Scott William Hubert | Physical Therapist | 143 Ridgewood Dr, San Rafael, CA 94901-1136 | 2018-01-20 |
| 1992231781 | Michael Raymond Verolini | Physical Therapist | 757 Bamboo Ter, San Rafael, CA 94903-3117 | 2017-05-11 |
| 1790132470 | Donna Semenza Roche | Physical Therapist | 581 Woodbine Dr, San Rafael, CA 94903-2463 | 2016-05-23 |
| 1497126726 | Elise Tarrant | Physical Therapist | 126 Greenwood Ave, San Rafael, CA 94901-3625 | 2015-10-13 |
| 1730586769 | Benjamin Pierce Costa | Physical Therapist | 51 Lochinvar Rd, San Rafael, CA 94901-2446 | 2014-11-19 |
| 1154740223 | Tim Turner | Physical Therapist | 185 N Redwood Dr, Suite 150, San Rafael, CA 94903-1973 | 2014-04-15 |
| 1497040612 | Joan Barbara Collins | Physical Therapist | 32 River Oaks Rd, San Rafael, CA 94901-1036 | 2011-06-15 |
| 1841599495 | Cheryl Williams | Physical Therapist | 135 Tamal Vista Dr, San Rafael, CA 94901-1645 | 2011-03-22 |
| 1366684094 | Lucia D Miller | Physical Therapist | 86 Grande Paseo, San Rafael, CA 94903-1553 | 2009-03-26 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.