MEDICARE: MRS. KAREN MIYEKO HOPKINS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	OT 667	CA

General Provider Information

NPI Number	:	1255459574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN MIYEKO HOPKINS OTR

Provider Business Mailing Address
First Line	:	23080 JENSEN CT
Second Line	:
City	:	GRAND TERRACE
State	:	CA
Zip	:	92313-5570
Country	:	US
Telephone Number	:	909-783-4609
Fax Number	:

Provider Business Practice Location Address
First Line	:	9161 SIERRA AVE
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-4729
Country	:	US
Telephone Number	:	909-427-4073
Fax Number	:	909-427-4736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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