Provider Demographics
NPI:1699831776
Name:APPENRODT, KATHLEEN WOOD (OT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:WOOD
Last Name:APPENRODT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3025
Mailing Address - Country:US
Mailing Address - Phone:831-662-8218
Mailing Address - Fax:831-662-8218
Practice Address - Street 1:579 AUTO CENTER DR
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3727
Practice Address - Country:US
Practice Address - Phone:831-722-9680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5271225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist