Healthcare Provider Details

I. General information

NPI: 1386207454
Provider Name (Legal Business Name): RYAN PARKER KARNOSKI PHD, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4892 SAN PABLO DAM RD
EL SOBRANTE CA
94803-3222
US

IV. Provider business mailing address

4892 SAN PABLO DAM RD
EL SOBRANTE CA
94803-3222
US

V. Phone/Fax

Practice location:
  • Phone: 510-836-9567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number97271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: