Individual ProviderKelly Lynn AndrasikOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address725 Welch Rd, Rehabilitation Services - 3rd Floor, Palo Alto, CA 94304-1601(650) 497-8218PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Lynn Andrasik 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 ID1932470275Provider TypeIndividualFull NameAndrasik, Kelly LynnGenderFemaleSole ProprietorNoEnumeration Date1/18/2012Last Updated1/18/2012Contact InformationPractice LocationPractice Address725 Welch Rd, Rehabilitation Services - 3rd Floor, Palo Alto, CA 94304-1601Phone(650) 497-8218Fax(650) 497-8491Mailing LocationMailing Address725 Welch Rd, Rehabilitation Services - 3rd Floor, Palo Alto, CA 94304-1601Phone(650) 497-8218Fax(650) 497-8491Provider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11652CaliforniaCode225X00000XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense238537OregonProvider IdentifiersIDDescriptionIssuerID053305DescriptionMedicaidIssuerUnlistedCalifornia