Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XE0001X | Environmental Modification | 700 | CA |
N | 225XF0002X | Feeding, Eating & Swallowing | 700 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | 700 | CA |
N | 225XL0004X | Low Vision | ||
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 700 | CA |
NPI | 1942624408 |
---|---|
Provider Name | Karri Kennedy |
First Address | Benicia, CA 94510-2063 |
Second Address | Berkeley, CA 94704-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2014 |
Last Update Date | 04/02/2014 |