Provider Demographics
NPI:1942405212
Name:PICKETT, KAREN LOUISE (MS, OTRL)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LOUISE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LOUISE
Other - Last Name:BOYKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:206 FAIRWAY GLEN LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95139-1520
Mailing Address - Country:US
Mailing Address - Phone:408-281-1179
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:REHAB SERVICES
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT2121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist