Provider Demographics
NPI:1184702342
Name:WOOD, KARYN DANETTE (REGISTERED PHYSICAL)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:DANETTE
Last Name:WOOD
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Gender:F
Credentials:REGISTERED PHYSICAL
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Mailing Address - Street 1:907 EMBARCADERO DR # B
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4087
Mailing Address - Country:US
Mailing Address - Phone:916-933-1221
Mailing Address - Fax:916-966-0871
Practice Address - Street 1:6560 GREENBACK LANE
Practice Address - Street 2:#100
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621
Practice Address - Country:US
Practice Address - Phone:916-723-3372
Practice Address - Fax:916-722-5098
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2024-03-12
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Provider Licenses
StateLicense IDTaxonomies
CA11282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ16561ZMedicare PIN
CA0PT112820Medicare PIN