Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Jean Evenson

Individual provider Occupational Therapy Assistant · NPI 1487264651

Kelly Jean Evenson is an Occupational Therapy Assistant in Lakeport, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

1291 Craig Ave
Lakeport, CA 95453-5704
Phone: (707) 263-6382
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 4499 (CA)

Record details

NPI number1487264651
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 3, 2020
Last updated in NPPESAugust 3, 2020
Certification dateAugust 3, 2020

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