Healthcare Provider Details

I. General information

NPI: 1902849581
Provider Name (Legal Business Name): KARIN L SIMPSON SCHUBERT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3406 SHANGRI LA RD
LAFAYETTE CA
94549-2108
US

IV. Provider business mailing address

3406 SHANGRI LA RD
LAFAYETTE CA
94549-2108
US

V. Phone/Fax

Practice location:
  • Phone: 925-932-1357
  • Fax: 925-932-1357
Mailing address:
  • Phone: 925-932-1357
  • Fax: 925-932-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number7776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: