Provider Demographics
NPI:1205170727
Name:ROSCHKOWSKY, KATHERINE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:ROSCHKOWSKY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 TAYLOR CT APT 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-3636
Mailing Address - Country:US
Mailing Address - Phone:650-743-0847
Mailing Address - Fax:
Practice Address - Street 1:20400 SARATOGA LOS GATOS RD
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-5927
Practice Address - Country:US
Practice Address - Phone:408-741-2983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12535225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist