Provider Demographics
NPI:1437838992
Name:GARDNER, KAREN ELAINE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELAINE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ELAINE
Other - Last Name:BRINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:2206 ZABYN ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5774
Mailing Address - Country:US
Mailing Address - Phone:760-525-0826
Mailing Address - Fax:
Practice Address - Street 1:2206 ZABYN ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5774
Practice Address - Country:US
Practice Address - Phone:760-525-0826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist