Provider Demographics
NPI:1912395187
Name:UYOD, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:UYOD
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 1:2584 CALLE SERENA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-3111
Mailing Address - Country:US
Mailing Address - Phone:619-274-3669
Mailing Address - Fax:
Practice Address - Street 1:27442 PORTOLA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2823
Practice Address - Country:US
Practice Address - Phone:949-282-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA 2225224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant