Provider Demographics
NPI:1730237223
Name:SEADE, KAREN (MPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SEADE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4802
Mailing Address - Country:US
Mailing Address - Phone:310-478-6222
Mailing Address - Fax:310-478-6696
Practice Address - Street 1:1650 OAK ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-4802
Practice Address - Country:US
Practice Address - Phone:310-478-6222
Practice Address - Fax:310-478-6696
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist