Provider Demographics
NPI:1194937151
Name:OAKS, CAROLYN H (OTR)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:H
Last Name:OAKS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 BURRELL AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2711
Mailing Address - Country:US
Mailing Address - Phone:805-581-2747
Mailing Address - Fax:
Practice Address - Street 1:145 HODENCAMP RD
Practice Address - Street 2:100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5810
Practice Address - Country:US
Practice Address - Phone:805-449-3481
Practice Address - Fax:805-449-3488
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5941225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist