Provider Demographics
NPI:1225013030
Name:NEWMAN, CAROLYN ALENE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ALENE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2169 MABRY DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2115
Mailing Address - Country:US
Mailing Address - Phone:916-928-1959
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:LAWRENCE J. ELLISON BUILDING , SUITE 1100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6715
Practice Address - Fax:916-734-7144
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1835225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation