Healthcare Provider Details

I. General information

NPI: 1932487857
Provider Name (Legal Business Name): KAREN L HODGES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 30TH ST STE 3
OAKLAND CA
94609-3374
US

IV. Provider business mailing address

419 30TH ST STE 3
OAKLAND CA
94609-3374
US

V. Phone/Fax

Practice location:
  • Phone: 628-400-7696
  • Fax:
Mailing address:
  • Phone: 628-400-7696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number37991
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number37991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: