Provider Demographics
NPI:1851463939
Name:ROMINES, KAREN ANITA (DPM)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANITA
Last Name:ROMINES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-5109
Mailing Address - Country:US
Mailing Address - Phone:909-599-0981
Mailing Address - Fax:909-614-8185
Practice Address - Street 1:11925 RUBILITE WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8071
Practice Address - Country:US
Practice Address - Phone:916-743-4593
Practice Address - Fax:209-474-0430
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0E2864213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E28640Medicaid
CAT11503Medicare UPIN
CA000E28640Medicaid