Individual ProviderKelsy WallaceOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address620 Sand Hill Rd, Palo Alto, CA 94304-2002(888) 926-1850(650) 392-5552PECOS EnrollmentBased on the most recent information from CMS, provider Kelsy Wallace does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1487325304Provider TypeIndividualFull NameWallace, KelsyCredentialOTRGenderFemaleSole ProprietorYesEnumeration Date9/21/2021Last Updated9/21/2021Contact InformationPractice LocationPractice Address620 Sand Hill Rd, Palo Alto, CA 94304-2002Phone(888) 926-1850FaxUnlisted FaxMailing LocationMailing Address1125 Park Pl Apt 122, San Mateo, CA 94403-1578Phone(650) 392-5552FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense22827California