Provider Demographics
NPI:1013245216
Name:ADIGUE, KAREN JOY TIU (PT)
Entity Type:Individual
Prefix:
First Name:KAREN JOY
Middle Name:TIU
Last Name:ADIGUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN JOY
Other - Middle Name:ADLAO
Other - Last Name:TIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:8520 SUNRISE WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828
Mailing Address - Country:US
Mailing Address - Phone:916-896-7089
Mailing Address - Fax:
Practice Address - Street 1:200 HAWTHORN ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2201
Practice Address - Country:US
Practice Address - Phone:508-997-9319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-27
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18865172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker