Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 15005 | CA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 15005 | CA |
NPI | 1073500674 |
---|---|
Provider Name | Karen Jane Woodbeck |
First Address | Campbell, CA 95008-6723 |
Second Address | Campbell, CA 95008-6723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 03/09/2009 |