Provider Demographics
NPI:1063579498
Name:JOUBERT, KAREN LEE (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:JOUBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:16610 CALLE BRITTANY
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272
Mailing Address - Country:US
Mailing Address - Phone:310-230-1627
Mailing Address - Fax:310-239-1653
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-385-9064
Practice Address - Fax:310-385-9264
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist