MEDICARE: CAROLYN H OAKS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	5941	CA

General Provider Information

NPI Number	:	1194937151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN H OAKS OTR

Provider Business Mailing Address
First Line	:	2105 BURRELL AVE
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2711
Country	:	US
Telephone Number	:	805-581-2747
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 HODENCAMP RD
Second Line	:	100
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-5810
Country	:	US
Telephone Number	:	805-449-3481
Fax Number	:	805-449-3488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	11/29/2021

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