Basic Information
Provider Information
NPI: 1487922571
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEMPER VERPLAETSE
FirstName: MICHELLE
MiddleName: DYAN
NamePrefix: MS.
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 246 CHENERY ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941312711
CountryCode: US
TelephoneNumber: 4153857658
FaxNumber:  
Practice Location
Address1: 650 CLARK WAY
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943042300
CountryCode: US
TelephoneNumber: 6503265530
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/05/2011
LastUpdateDate: 12/05/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X7805CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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