Provider Demographics
NPI:1952500753
Name:KAREN E BEERNINK
Entity Type:Organization
Organization Name:KAREN E BEERNINK
Other - Org Name:PHYSICAL REHABILITATION AND WELLNES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BEERNINK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, OCS
Authorized Official - Phone:925-287-0056
Mailing Address - Street 1:175 CLEAVELAND RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3875
Mailing Address - Country:US
Mailing Address - Phone:925-287-0056
Mailing Address - Fax:
Practice Address - Street 1:175 CLEAVELAND RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3875
Practice Address - Country:US
Practice Address - Phone:925-287-0056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19028261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT190280Medicare PIN