Healthcare Provider Details

I. General information

NPI: 1699831776
Provider Name (Legal Business Name): KATHLEEN WOOD APPENRODT OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 AUTO CENTER DR
WATSONVILLE CA
95076-3727
US

IV. Provider business mailing address

119 VICTORIA LN
APTOS CA
95003-3025
US

V. Phone/Fax

Practice location:
  • Phone: 831-722-9680
  • Fax:
Mailing address:
  • Phone: 831-662-8218
  • Fax: 831-662-8218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: