Healthcare Provider Details

I. General information

NPI: 1912786195
Provider Name (Legal Business Name): SMARIKA KOWALSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: N/A N/A KARKI

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9136 THILOW DR
SACRAMENTO CA
95826-4115
US

IV. Provider business mailing address

9136 THILOW DR
SACRAMENTO CA
95826-4115
US

V. Phone/Fax

Practice location:
  • Phone: 916-620-2160
  • Fax:
Mailing address:
  • Phone: 916-620-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003388
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: