Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT5560 | CA |
N | 225XF0002X | Feeding, Eating & Swallowing | OT5560 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | OT5560 | CA |
N | 225XM0800X | Mental Health | OT5560 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT5560 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT5560 | CA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT5560 | CA |
NPI | 1790331205 |
---|---|
Provider Name | Elizabeth A Karl |
First Address | Lakeport, CA 95453-6369 |
Second Address | Lakeport, CA 95453-6369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2019 |
Last Update Date | 12/08/2019 |