Healthcare Provider Details

I. General information

NPI: 1215912100
Provider Name (Legal Business Name): KAREN L COMBRINK PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 MARSHALL WAY
SACRAMENTO CA
95818-3544
US

IV. Provider business mailing address

2116 MARSHALL WAY
SACRAMENTO CA
95818-3544
US

V. Phone/Fax

Practice location:
  • Phone: 916-455-1964
  • Fax:
Mailing address:
  • Phone: 916-455-1964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT5419
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: