Provider Demographics
NPI:1588628200
Name:SMITH, KAREN CECILIA (OTR L)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CECILIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8724 SUMMER POINTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-3424
Mailing Address - Country:US
Mailing Address - Phone:916-689-0990
Mailing Address - Fax:
Practice Address - Street 1:1300 NATIONAL DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1992
Practice Address - Country:US
Practice Address - Phone:916-928-5973
Practice Address - Fax:916-928-2507
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT27225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist