Provider Demographics
NPI:1679630305
Name:PIMENTEL, KAREN LINDSAY (OTRL CHT CWCE CEAS)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LINDSAY
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:OTRL CHT CWCE CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:7005 N MAPLE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8009
Mailing Address - Country:US
Mailing Address - Phone:559-325-3503
Mailing Address - Fax:559-325-3504
Practice Address - Street 1:7005 N MAPLE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8009
Practice Address - Country:US
Practice Address - Phone:559-325-3503
Practice Address - Fax:559-325-3504
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT397225XH1200X
225XE1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4831990001OtherDMERC
CACT0003970Medicaid
CAZZZ16215ZMedicare ID - Type UnspecifiedINDIVIDUAL
CACT0003970Medicaid