Provider Demographics
NPI:1285657171
Name:BEERNINK, KAREN ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:BEERNINK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CLEAVELAND RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3875
Mailing Address - Country:US
Mailing Address - Phone:925-287-0056
Mailing Address - Fax:925-287-0057
Practice Address - Street 1:175 CLEAVELAND RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3875
Practice Address - Country:US
Practice Address - Phone:925-287-0056
Practice Address - Fax:925-287-0057
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAPT190282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACAPT19028OtherPT LICENSE NUMBER
CA0PT190280Medicare ID - Type UnspecifiedPHYSICAL THERAPY