Healthcare Provider Details

I. General information

NPI: 1487520276
Provider Name (Legal Business Name): KARLIE CONTRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12437 LEWIS ST STE 7
GARDEN GROVE CA
92840-4673
US

IV. Provider business mailing address

710 N PLEASANT AVE APT 6
LODI CA
95240-1160
US

V. Phone/Fax

Practice location:
  • Phone: 714-202-0118
  • Fax:
Mailing address:
  • Phone: 209-373-3644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: