Children's Therapy Center
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To expedite your first visit, you may fill out the following forms beforehand:
Patient Demographic Form
HIPAA Consent Form
Occupational Therapy Questionnaire
Physical Therapy Questionnaire
Speech Therapy Questionnaire
Feeding Questionnaire
Caregiver Questionnaire (Sensory Profile)
397 Mobil Avenue
Camarillo, CA 93010
Phone:  (805) 383-1501
​Fax:  (805) 384-0478
Occupational Therapy — Beth Maulhardt, OTR/L 
Physical Therapy — Keiko Goji, DPT
Psychology — Valerie Cummings, PhD
Speech-Language Pathology — Nancy M. Wigert, MA CCC-SLP
  • Home
  • Our Services
  • Signs/Symptoms
  • Forms
  • Payment
  • Contact Us