Provider Demographics
NPI:1124343744
Name:CARREY, KAREN K (MA, OTR/L)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:CARREY
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-3130
Mailing Address - Country:US
Mailing Address - Phone:310-650-8065
Mailing Address - Fax:310-394-8476
Practice Address - Street 1:1431 7TH ST
Practice Address - Street 2:STE 203
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2637
Practice Address - Country:US
Practice Address - Phone:310-650-8065
Practice Address - Fax:310-394-8476
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 10190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist