Provider Demographics
NPI:1235419656
Name:STANTON, KAREN GEORGINA (OT/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GEORGINA
Last Name:STANTON
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28221 BALKINS DR
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1805
Mailing Address - Country:US
Mailing Address - Phone:510-459-3589
Mailing Address - Fax:
Practice Address - Street 1:28221 BALKINS DR
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1805
Practice Address - Country:US
Practice Address - Phone:510-459-3589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7866225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics