Provider Demographics
NPI:1811212046
Name:ABENHEIM, KARIN
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:ABENHEIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4418
Mailing Address - Country:US
Mailing Address - Phone:650-323-7416
Mailing Address - Fax:
Practice Address - Street 1:1308 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4418
Practice Address - Country:US
Practice Address - Phone:650-323-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9231225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R28248410OtherBLUECROSSBUE SHIELD