Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT10 | CA |
NPI | 1013247444 |
---|---|
Provider Name | Karen Jenks |
First Address | Saratoga, CA 95070-4756 |
Second Address | Los Gatos, CA 95032-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2010 |
Last Update Date | 11/02/2010 |