MEDICARE: MS. KAREN ELYSE WRIGHT PTA

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	225100000X	Physical Therapist	2460	CA
2	225200000X	Physical Therapy Assistant	2460	CO

General Provider Information

NPI Number	:	1831210962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN ELYSE WRIGHT PTA

Provider Business Mailing Address
First Line	:	204 CALLE FANILLIA
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-3736
Country	:	US
Telephone Number	:	818-991-3945
Fax Number	:	818-991-3945

Provider Business Practice Location Address
First Line	:	4655 RUFFNER ST
Second Line	:	#270
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2275
Country	:	US
Telephone Number	:	800-787-6787
Fax Number	:	800-787-6762

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	09/11/2025

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