Provider Demographics
NPI:1467684720
Name:RORK, KARRY SUE (BSW)
Entity Type:Individual
Prefix:
First Name:KARRY
Middle Name:SUE
Last Name:RORK
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6296 RIVER CREST DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0738
Mailing Address - Country:US
Mailing Address - Phone:951-791-3582
Mailing Address - Fax:
Practice Address - Street 1:6296 RIVER CREST DR
Practice Address - Street 2:SUITE K
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0738
Practice Address - Country:US
Practice Address - Phone:951-791-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator