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

Kimberly A Peterson, OT

Individual provider Occupational Therapist · NPI 1104336668

Kimberly A Peterson, OT is an Occupational Therapist in Private Practice in Davis, California. Qualified in 2015, 11 years ago. Practices with Sutter Valley Medical Foundation, a 2,464-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2017
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

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Practice location Address checks out

1340 Lake Blvd
Davis, CA 95616-5673
Phone: (530) 753-5338
Fax: (530) 753-4609
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT17912 (CA)

Record details

NPI number1104336668
Entity typeIndividual (Type 1)
GenderFemale
Credentials OT
Sole proprietorNo
NPI enumeratedOctober 10, 2017
Last updated in NPPESAugust 30, 2023
Certification dateAugust 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Sutter Valley Medical Foundation — 2464 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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