Provider Demographics
NPI:1003927344
Name:ROITZ, KAREN KANE (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KANE
Last Name:ROITZ
Suffix:
Gender:F
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SEABRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2529
Mailing Address - Country:US
Mailing Address - Phone:831-425-3588
Mailing Address - Fax:831-425-3538
Practice Address - Street 1:1510 SEABRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2529
Practice Address - Country:US
Practice Address - Phone:831-425-3588
Practice Address - Fax:831-425-3538
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24576111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0245760Medicare ID - Type UnspecifiedMEDICARE NUMBER