Provider Demographics
NPI:1023453198
Name:ROGERS, KAREN Y (MA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:Y
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:Y
Other - Last Name:PECCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3036 CHANCERY PL
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5350
Mailing Address - Country:US
Mailing Address - Phone:805-558-6169
Mailing Address - Fax:
Practice Address - Street 1:6340 VARIEL AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2514
Practice Address - Country:US
Practice Address - Phone:818-888-4559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
13402225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics